Provider Demographics
NPI:1942870456
Name:AMAYA, KATHERYNE M
Entity Type:Individual
Prefix:
First Name:KATHERYNE
Middle Name:M
Last Name:AMAYA
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 1:1806 ORIOLE CT
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-3123
Mailing Address - Country:US
Mailing Address - Phone:301-844-8302
Mailing Address - Fax:
Practice Address - Street 1:4401 CLERMONT DR NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4952
Practice Address - Country:US
Practice Address - Phone:202-445-9416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant