Provider Demographics
NPI:1437628849
Name:PASCHALL, JEANNIENNE YOLONDA
Entity Type:Individual
Prefix:
First Name:JEANNIENNE
Middle Name:YOLONDA
Last Name:PASCHALL
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 1:4303 23RD PL
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-3211
Mailing Address - Country:US
Mailing Address - Phone:202-630-9875
Mailing Address - Fax:
Practice Address - Street 1:2606 18TH ST SE APT C
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3259
Practice Address - Country:US
Practice Address - Phone:706-621-0469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant