Provider Demographics
NPI:1740775048
Name:PRICE, STEPHANIE ANTIONETTE I
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANTIONETTE
Last Name:PRICE
Suffix:I
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 1:4269 EDSON PL NE APT A
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-8024
Mailing Address - Country:US
Mailing Address - Phone:202-384-9479
Mailing Address - Fax:
Practice Address - Street 1:4269 EDSON PL NE APT A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-8024
Practice Address - Country:US
Practice Address - Phone:202-384-9479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant