Provider Demographics
NPI:1437864154
Name:WHIPPLE, TICHANTA JEMAE
Entity type:Individual
Prefix:MS
First Name:TICHANTA
Middle Name:JEMAE
Last Name:WHIPPLE
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 1:1200 N CAPITOL ST NW APT A713
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-7529
Mailing Address - Country:US
Mailing Address - Phone:202-817-8711
Mailing Address - Fax:
Practice Address - Street 1:1200 N CAPITOL ST NW APT A713
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7529
Practice Address - Country:US
Practice Address - Phone:202-817-8711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant