Provider Demographics
NPI:1497283824
Name:SALTER, ANGELA JEANETTE
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:JEANETTE
Last Name:SALTER
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 1:4739 BIDEFORD SQ
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6162
Mailing Address - Country:US
Mailing Address - Phone:202-821-8611
Mailing Address - Fax:
Practice Address - Street 1:3627 HORNER PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2476
Practice Address - Country:US
Practice Address - Phone:202-561-1107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide