Provider Demographics
NPI:1750861001
Name:HERBIN, DENISE SEDALE
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:SEDALE
Last Name:HERBIN
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 1:15819 PALAI TURN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1636
Mailing Address - Country:US
Mailing Address - Phone:202-595-4417
Mailing Address - Fax:
Practice Address - Street 1:1264 RAUM ST NE APT 10
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2471
Practice Address - Country:US
Practice Address - Phone:202-285-5176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide