Provider Demographics
NPI:1366069650
Name:HALL, ALTIMESE R
Entity type:Individual
Prefix:
First Name:ALTIMESE
Middle Name:R
Last Name:HALL
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 1:3200 MINNESOTA AVE SE APT 3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-2214
Mailing Address - Country:US
Mailing Address - Phone:202-591-9861
Mailing Address - Fax:
Practice Address - Street 1:1221 M ST NW APT 816
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-5164
Practice Address - Country:US
Practice Address - Phone:202-789-4252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant