Provider Demographics
NPI:1164147245
Name:SHORTER, ZYAH TREANNA
Entity Type:Individual
Prefix:
First Name:ZYAH
Middle Name:TREANNA
Last Name:SHORTER
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 1:5219 DAVENTRY TER
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2774
Mailing Address - Country:US
Mailing Address - Phone:240-853-2852
Mailing Address - Fax:
Practice Address - Street 1:2515 R ST SE APT 326
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3970
Practice Address - Country:US
Practice Address - Phone:202-575-8820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant