Provider Demographics
NPI:1497494546
Name:WHITMIRE, JOVONNA ANNE (DC)
Entity Type:Individual
Prefix:
First Name:JOVONNA
Middle Name:ANNE
Last Name:WHITMIRE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4660 MARTIN LUTHER KING JR AVE SW APT B403
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4978
Mailing Address - Country:US
Mailing Address - Phone:202-926-6767
Mailing Address - Fax:
Practice Address - Street 1:2524 NAYLOR RD SE APT 102
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4024
Practice Address - Country:US
Practice Address - Phone:202-840-3348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC00TQ3T63747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant