Provider Demographics
NPI:1972029767
Name:MAKUETE, CATHY DJOTSOP
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:DJOTSOP
Last Name:MAKUETE
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 1:4910 FORT TOTTEN DR NE APT 12
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-7527
Mailing Address - Country:US
Mailing Address - Phone:202-873-5585
Mailing Address - Fax:
Practice Address - Street 1:4910 FORT TOTTEN DR NE APT 12
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-7527
Practice Address - Country:US
Practice Address - Phone:202-873-5585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13004374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty