Provider Demographics
NPI:1760743595
Name:EASTERWOOD, JANICE YVONNE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:YVONNE
Last Name:EASTERWOOD
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 1:1230 PENN ST NE
Mailing Address - Street 2:APT#4
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2810
Mailing Address - Country:US
Mailing Address - Phone:202-270-2656
Mailing Address - Fax:
Practice Address - Street 1:1230 PENN ST NE
Practice Address - Street 2:APT#4
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2810
Practice Address - Country:US
Practice Address - Phone:202-270-2656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide