Provider Demographics
NPI:1629735873
Name:SUTTON, DEMETRIA ANN
Entity Type:Individual
Prefix:
First Name:DEMETRIA
Middle Name:ANN
Last Name:SUTTON
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 1:2203 WEBER DR
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1247
Mailing Address - Country:US
Mailing Address - Phone:202-285-3977
Mailing Address - Fax:
Practice Address - Street 1:201 58TH ST NE APT 202
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-6815
Practice Address - Country:US
Practice Address - Phone:202-285-3977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant