Provider Demographics
NPI:1518200997
Name:YARBOROUGH, CHANITA RENEE
Entity Type:Individual
Prefix:
First Name:CHANITA
Middle Name:RENEE
Last Name:YARBOROUGH
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 1:2759 31TH PL
Mailing Address - Street 2:NE
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018
Mailing Address - Country:US
Mailing Address - Phone:202-262-9721
Mailing Address - Fax:
Practice Address - Street 1:7506 GEORGIA AVENUE
Practice Address - Street 2:DC
Practice Address - City:WASHINGTON DC
Practice Address - State:DC
Practice Address - Zip Code:20012
Practice Address - Country:US
Practice Address - Phone:202-291-6973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide