Provider Demographics
NPI:1366024317
Name:SNIPE RIVERS, SEMONE M
Entity Type:Individual
Prefix:
First Name:SEMONE
Middle Name:M
Last Name:SNIPE RIVERS
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 1:116 T ST NE APT 244
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-5122
Mailing Address - Country:US
Mailing Address - Phone:202-749-1277
Mailing Address - Fax:
Practice Address - Street 1:116 T ST NE APT 244
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5122
Practice Address - Country:US
Practice Address - Phone:202-749-1277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCNA0000812834Medicaid