Provider Demographics
NPI:1972190700
Name:HOWARD-CHITTAMS, PATRICIA L (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:HOWARD-CHITTAMS
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1647 BENNING RD NE STE 302
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4572
Mailing Address - Country:US
Mailing Address - Phone:202-398-2100
Mailing Address - Fax:
Practice Address - Street 1:1647 BENNING RD NE STE 302
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4572
Practice Address - Country:US
Practice Address - Phone:202-558-0504
Practice Address - Fax:202-558-0508
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN61646363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty