Provider Demographics
NPI:1851653554
Name:ATCHON, KOSSI (HHA)
Entity Type:Individual
Prefix:MR
First Name:KOSSI
Middle Name:
Last Name:ATCHON
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 DREXEL ST APT 302
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-4102
Mailing Address - Country:US
Mailing Address - Phone:571-277-5977
Mailing Address - Fax:
Practice Address - Street 1:2101 RHODE ISLAND AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2836
Practice Address - Country:US
Practice Address - Phone:202-526-1230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-09
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide