Provider Demographics
NPI:1164780839
Name:FLYTHE, ADOSHIA L
Entity Type:Individual
Prefix:
First Name:ADOSHIA
Middle Name:L
Last Name:FLYTHE
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 1:1520 2ND ST SW
Mailing Address - Street 2:APT 22
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-3430
Mailing Address - Country:US
Mailing Address - Phone:202-438-3937
Mailing Address - Fax:
Practice Address - Street 1:1520 2ND ST SW
Practice Address - Street 2:APT 22
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-3430
Practice Address - Country:US
Practice Address - Phone:202-438-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide