Provider Demographics
NPI:1265158521
Name:WYNTER, NELLEISHA ABOSEDE NADINE
Entity type:Individual
Prefix:
First Name:NELLEISHA
Middle Name:ABOSEDE NADINE
Last Name:WYNTER
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 1:1212 GALLATIN ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-6916
Mailing Address - Country:US
Mailing Address - Phone:202-883-0099
Mailing Address - Fax:
Practice Address - Street 1:2201 SAVANNAH ST SE APT 305
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7586
Practice Address - Country:US
Practice Address - Phone:202-427-5844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant