Provider Demographics
NPI:1831621317
Name:HEMSLEY, SHELIA
Entity type:Individual
Prefix:
First Name:SHELIA
Middle Name:
Last Name:HEMSLEY
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 1:2350 PITTS PL SE APT 202
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-4988
Mailing Address - Country:US
Mailing Address - Phone:202-889-4299
Mailing Address - Fax:
Practice Address - Street 1:2350 PITTS PL SE APT 202
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4988
Practice Address - Country:US
Practice Address - Phone:202-889-4299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC214-30-0195305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC7026979Medicaid