Provider Demographics
NPI:1689329435
Name:DC CARE PLLC
Entity Type:Organization
Organization Name:DC CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:202-568-6579
Mailing Address - Street 1:4822 41ST ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-1708
Mailing Address - Country:US
Mailing Address - Phone:910-384-5664
Mailing Address - Fax:
Practice Address - Street 1:4822 41ST ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-1708
Practice Address - Country:US
Practice Address - Phone:202-568-6579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty