Provider Demographics
NPI:1467213405
Name:BASIL, JANAE LASHAWNE
Entity Type:Individual
Prefix:
First Name:JANAE
Middle Name:LASHAWNE
Last Name:BASIL
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 1:5906 ROBIN LN
Mailing Address - Street 2:
Mailing Address - City:CAMP SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20746-5116
Mailing Address - Country:US
Mailing Address - Phone:202-892-8316
Mailing Address - Fax:
Practice Address - Street 1:5906 ROBIN LN
Practice Address - Street 2:
Practice Address - City:CAMP SPRINGS
Practice Address - State:MD
Practice Address - Zip Code:20746-5116
Practice Address - Country:US
Practice Address - Phone:202-892-8316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant