Provider Demographics
NPI:1366933103
Name:ESCOBAR, GLORIA STEPHANIE (HHA)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:STEPHANIE
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:STEPHANIE
Other - Last Name:ESCOBAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HHA
Mailing Address - Street 1:3030 SHERMAN AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3914
Mailing Address - Country:US
Mailing Address - Phone:202-553-8202
Mailing Address - Fax:
Practice Address - Street 1:3030 SHERMAN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3914
Practice Address - Country:US
Practice Address - Phone:202-553-8202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide