Provider Demographics
NPI:1952948226
Name:THOMPSON, CHANTEY EVAN
Entity Type:Individual
Prefix:MISS
First Name:CHANTEY
Middle Name:EVAN
Last Name:THOMPSON
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 1:2950 VAN NESS STREET N.W.
Mailing Address - Street 2:312
Mailing Address - City:WASHINGTON DC
Mailing Address - State:DC
Mailing Address - Zip Code:20008
Mailing Address - Country:US
Mailing Address - Phone:202-905-5107
Mailing Address - Fax:
Practice Address - Street 1:2412 POMEROY ROAD S.E.
Practice Address - Street 2:T-1
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2002
Practice Address - Country:US
Practice Address - Phone:202-248-2115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant