Provider Demographics
NPI:1164089785
Name:TAAH, PRESCILIA ENJEI
Entity Type:Individual
Prefix:
First Name:PRESCILIA
Middle Name:ENJEI
Last Name:TAAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 11TH ST NE APT 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3750
Mailing Address - Country:US
Mailing Address - Phone:202-621-3015
Mailing Address - Fax:
Practice Address - Street 1:714 11TH ST NE APT 101
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3750
Practice Address - Country:US
Practice Address - Phone:202-621-3015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14463374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide