Provider Demographics
NPI:1740541192
Name:GARNER, NICOLA S
Entity type:Individual
Prefix:
First Name:NICOLA
Middle Name:S
Last Name:GARNER
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 1:1605 ISHERWOOD ST NE APT 4
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-5527
Mailing Address - Country:US
Mailing Address - Phone:240-421-6447
Mailing Address - Fax:
Practice Address - Street 1:1605 ISHERWOOD ST NE APT 4
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5527
Practice Address - Country:US
Practice Address - Phone:240-421-6447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide