Provider Demographics
NPI:1700145315
Name:LOOPER, JOSEPHINE NYAHN
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:NYAHN
Last Name:LOOPER
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 1:3186 BERRY RD NE
Mailing Address - Street 2:1/2
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-1610
Mailing Address - Country:US
Mailing Address - Phone:202-557-1579
Mailing Address - Fax:
Practice Address - Street 1:3186 BERRY RD NE
Practice Address - Street 2:1/2
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1610
Practice Address - Country:US
Practice Address - Phone:202-557-1579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide