Provider Demographics
NPI:1013429257
Name:JINOR, PRISCA
Entity Type:Individual
Prefix:
First Name:PRISCA
Middle Name:
Last Name:JINOR
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 1:5632 LIVINGSTON TER APT 202
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-2466
Mailing Address - Country:US
Mailing Address - Phone:240-441-6407
Mailing Address - Fax:
Practice Address - Street 1:5632 LIVINGSTON TER APT 202
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-2466
Practice Address - Country:US
Practice Address - Phone:240-441-6407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13170374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide