Provider Demographics
NPI:1477145324
Name:MARRIOTT, ANNETTA NATASHA
Entity Type:Individual
Prefix:MISS
First Name:ANNETTA
Middle Name:NATASHA
Last Name:MARRIOTT
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 1:3578 POWDER MILL RD APT 102
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3527
Mailing Address - Country:US
Mailing Address - Phone:240-501-0340
Mailing Address - Fax:
Practice Address - Street 1:911 HAMLIN ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-3421
Practice Address - Country:US
Practice Address - Phone:240-855-8865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant