Provider Demographics
NPI:1184276198
Name:MCQUEEN, LILLIEMAE TASHEEMA
Entity type:Individual
Prefix:
First Name:LILLIEMAE
Middle Name:TASHEEMA
Last Name:MCQUEEN
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 1:212 36TH ST NE APT 4
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-2633
Mailing Address - Country:US
Mailing Address - Phone:202-553-7222
Mailing Address - Fax:
Practice Address - Street 1:201 36TH ST NE APT 104
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2664
Practice Address - Country:US
Practice Address - Phone:202-398-2198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant