Provider Demographics
NPI:1902395429
Name:POLK, KATRINA (AA, BA, MPA & PHD)
Entity Type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:
Last Name:POLK
Suffix:
Gender:F
Credentials:AA, BA, MPA & PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 TUBMAN RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-2841
Mailing Address - Country:US
Mailing Address - Phone:833-322-4464
Mailing Address - Fax:
Practice Address - Street 1:1885 TUBMAN RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2841
Practice Address - Country:US
Practice Address - Phone:833-322-4464
Practice Address - Fax:833-322-4464
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care