Provider Demographics
NPI:1922516798
Name:ATAWAN, LIVILIA
Entity Type:Individual
Prefix:
First Name:LIVILIA
Middle Name:
Last Name:ATAWAN
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 1:2400 QUEENS CHAPEL RD APT 105
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3631
Mailing Address - Country:US
Mailing Address - Phone:202-393-9853
Mailing Address - Fax:
Practice Address - Street 1:2400 QUEENS CHAPEL RD APT 105
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3631
Practice Address - Country:US
Practice Address - Phone:202-393-9853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13347374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide