Provider Demographics
NPI:1417657099
Name:ANDREWS, GWENDOLYN DIANE
Entity Type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:DIANE
Last Name:ANDREWS
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 1:1725 GAINESVILLE ST SE APT 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-3265
Mailing Address - Country:US
Mailing Address - Phone:202-257-6307
Mailing Address - Fax:
Practice Address - Street 1:1725 GAINESVILLE ST SE APT 101
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3265
Practice Address - Country:US
Practice Address - Phone:202-257-6307
Practice Address - Fax:202-561-3719
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide