Provider Demographics
NPI:1205566437
Name:FOREMAN, RENA LANITA
Entity type:Individual
Prefix:
First Name:RENA
Middle Name:LANITA
Last Name:FOREMAN
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 1:713 BRANDYWINE ST S.E.
Mailing Address - Street 2:APT, 303
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3568
Mailing Address - Country:US
Mailing Address - Phone:240-510-4867
Mailing Address - Fax:
Practice Address - Street 1:3760 MINNESOTA AVE NE APT 612
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2663
Practice Address - Country:US
Practice Address - Phone:202-321-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-11
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant