Provider Demographics
NPI:1629892161
Name:CHASE, JAVELLE LENISE
Entity type:Individual
Prefix:
First Name:JAVELLE
Middle Name:LENISE
Last Name:CHASE
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 1:912 IRVINGTON ST
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-2862
Mailing Address - Country:US
Mailing Address - Phone:202-487-5006
Mailing Address - Fax:
Practice Address - Street 1:912 IRVINGTON ST
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-2862
Practice Address - Country:US
Practice Address - Phone:202-487-5006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant