Provider Demographics
NPI:1043683006
Name:NJEI, GRACE
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:NJEI
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 1:741 LONGFELLOW ST NW APT 401
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-3027
Mailing Address - Country:US
Mailing Address - Phone:240-429-2552
Mailing Address - Fax:
Practice Address - Street 1:741 LONGFELLOW ST NW APT 401
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-3027
Practice Address - Country:US
Practice Address - Phone:240-429-2552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide