Provider Demographics
NPI:1447826060
Name:LI, JENNY
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:LI
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 1:2360 CHAMPLAIN ST NW APT 24
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-8611
Mailing Address - Country:US
Mailing Address - Phone:202-280-0377
Mailing Address - Fax:
Practice Address - Street 1:401 K ST NW APT 907
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-5208
Practice Address - Country:US
Practice Address - Phone:202-288-3229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant