Provider Demographics
NPI:1043966302
Name:CHASE, RENEE LATANAIA
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:LATANAIA
Last Name:CHASE
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 1:10209 LILY GREEN CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-6665
Mailing Address - Country:US
Mailing Address - Phone:240-470-0568
Mailing Address - Fax:
Practice Address - Street 1:105 Q ST NW APT 201
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1158
Practice Address - Country:US
Practice Address - Phone:202-232-0467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant