Provider Demographics
NPI:1710510128
Name:SIMMONS-HASAN, CARMESHA L
Entity Type:Individual
Prefix:
First Name:CARMESHA
Middle Name:L
Last Name:SIMMONS-HASAN
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 1:1233 VALLEY AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4354
Mailing Address - Country:US
Mailing Address - Phone:202-569-7110
Mailing Address - Fax:
Practice Address - Street 1:1233 VALLEY AVE SE APT 102
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4362
Practice Address - Country:US
Practice Address - Phone:202-569-7110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide