Provider Demographics
NPI:1497228878
Name:SKEEN, JOANN BEVERLY
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:BEVERLY
Last Name:SKEEN
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 1:4417 QUARLES ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-2018
Mailing Address - Country:US
Mailing Address - Phone:202-840-3259
Mailing Address - Fax:
Practice Address - Street 1:779 19TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4766
Practice Address - Country:US
Practice Address - Phone:202-396-4557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide