Provider Demographics
NPI:1639710510
Name:DACONCEICAO, LEATRICE ANN
Entity Type:Individual
Prefix:MRS
First Name:LEATRICE
Middle Name:ANN
Last Name:DACONCEICAO
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 1:3411 CLAIRE DR APT 202
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-2511
Mailing Address - Country:US
Mailing Address - Phone:240-606-5415
Mailing Address - Fax:
Practice Address - Street 1:1715 STANTON TER SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2823
Practice Address - Country:US
Practice Address - Phone:202-907-6598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker