Provider Demographics
NPI:1609447663
Name:TERRELL, LAWANE
Entity Type:Individual
Prefix:
First Name:LAWANE
Middle Name:
Last Name:TERRELL
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 1:6522 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3106
Mailing Address - Country:US
Mailing Address - Phone:240-676-2868
Mailing Address - Fax:
Practice Address - Street 1:1211 23RD ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1282
Practice Address - Country:US
Practice Address - Phone:202-957-1135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No347C00000XTransportation ServicesPrivate Vehicle