Provider Demographics
NPI:1750826749
Name:HINES, NARSIMA LATISHA
Entity type:Individual
Prefix:
First Name:NARSIMA
Middle Name:LATISHA
Last Name:HINES
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 1:3911 23RD PKWY
Mailing Address - Street 2:APT.21
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-6642
Mailing Address - Country:US
Mailing Address - Phone:240-772-8280
Mailing Address - Fax:
Practice Address - Street 1:3911 23RD PKWY
Practice Address - Street 2:APT.21
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-6642
Practice Address - Country:US
Practice Address - Phone:240-772-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC376K00000X376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide