Provider Demographics
NPI:1952662025
Name:EPIE, CALISTA
Entity Type:Individual
Prefix:
First Name:CALISTA
Middle Name:
Last Name:EPIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CALISTA
Other - Middle Name:
Other - Last Name:EPIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7831 RIVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-4016
Mailing Address - Country:US
Mailing Address - Phone:202-621-7329
Mailing Address - Fax:
Practice Address - Street 1:7831 RIVERDALE RD
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-4016
Practice Address - Country:US
Practice Address - Phone:202-621-7329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide