Provider Demographics
NPI:1891380226
Name:GROTE, EVELYN
Entity Type:Individual
Prefix:MISS
First Name:EVELYN
Middle Name:
Last Name:GROTE
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 1:5626 WHITFIELD CHAPEL RD APT 301
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2551
Mailing Address - Country:US
Mailing Address - Phone:631-639-8520
Mailing Address - Fax:
Practice Address - Street 1:2908 16TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1822
Practice Address - Country:US
Practice Address - Phone:202-269-0375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant