Provider Demographics
NPI:1629595061
Name:FRANCISCO, TERESA
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:FRANCISCO
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 1:1 YELLOW LEAF CT
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-1361
Mailing Address - Country:US
Mailing Address - Phone:240-510-7842
Mailing Address - Fax:
Practice Address - Street 1:1 YELLOW LEAF CT
Practice Address - Street 2:
Practice Address - City:GERMATOWN
Practice Address - State:MD
Practice Address - Zip Code:20876
Practice Address - Country:US
Practice Address - Phone:240-510-7842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12986374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCHHA11986Medicaid
MDF652789440237Medicaid