Provider Demographics
NPI:1285217083
Name:GARNER, SHIRLETTE CHARNETTA
Entity Type:Individual
Prefix:
First Name:SHIRLETTE
Middle Name:CHARNETTA
Last Name:GARNER
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 1:3739 JAY STREET N.E
Mailing Address - Street 2:3
Mailing Address - City:DC
Mailing Address - State:DC
Mailing Address - Zip Code:20019
Mailing Address - Country:US
Mailing Address - Phone:202-644-3789
Mailing Address - Fax:
Practice Address - Street 1:3677 JAY STREET N.E
Practice Address - Street 2:204
Practice Address - City:DC
Practice Address - State:DC
Practice Address - Zip Code:20019
Practice Address - Country:US
Practice Address - Phone:202-894-0238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant