Provider Demographics
NPI:1417438367
Name:RHODES, SEBRENA LEINORRIS
Entity Type:Individual
Prefix:
First Name:SEBRENA
Middle Name:LEINORRIS
Last Name:RHODES
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 1:1854 CENTRAL PL NE APT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1743
Mailing Address - Country:US
Mailing Address - Phone:202-945-3006
Mailing Address - Fax:
Practice Address - Street 1:5037 QUEENS STROLL PL SE UNIT B
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-6113
Practice Address - Country:US
Practice Address - Phone:202-910-9161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant