Provider Demographics
NPI:1356157218
Name:DAVIS-FREEMAN, JENINE
Entity type:Individual
Prefix:MRS
First Name:JENINE
Middle Name:
Last Name:DAVIS-FREEMAN
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 1:1713 GAINESVILLE ST SE APT 301
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-3267
Mailing Address - Country:US
Mailing Address - Phone:202-386-8128
Mailing Address - Fax:
Practice Address - Street 1:1713 GAINESVILLE ST SE APT 301
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3267
Practice Address - Country:US
Practice Address - Phone:202-386-8118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant