Provider Demographics
NPI:1629564059
Name:KARIMI, JANE KEBASO
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:KEBASO
Last Name:KARIMI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JANE
Other - Middle Name:KEBASO
Other - Last Name:KARIMI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HHA
Mailing Address - Street 1:7700 HANOVER PKWY APT 103
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2637
Mailing Address - Country:US
Mailing Address - Phone:202-390-1254
Mailing Address - Fax:
Practice Address - Street 1:1610 COLUMBIA RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-3608
Practice Address - Country:US
Practice Address - Phone:202-322-5562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13804374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide