Provider Demographics
NPI:1811733991
Name:PROPHET, ERNESTINE D
Entity type:Individual
Prefix:MISS
First Name:ERNESTINE
Middle Name:D
Last Name:PROPHET
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 1:1439 ROXANNA RD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1225
Mailing Address - Country:US
Mailing Address - Phone:240-758-6802
Mailing Address - Fax:
Practice Address - Street 1:1439 ROXANNA RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1225
Practice Address - Country:US
Practice Address - Phone:240-758-6802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant