Provider Demographics
NPI:1346007259
Name:HUMPHREY, SYREETA (CD(DONA))
Entity Type:Individual
Prefix:MS
First Name:SYREETA
Middle Name:
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6610 GUYER AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-2603
Mailing Address - Country:US
Mailing Address - Phone:202-480-9538
Mailing Address - Fax:
Practice Address - Street 1:6304 WINGATE ST APT 102
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-3624
Practice Address - Country:US
Practice Address - Phone:202-480-9538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula