Provider Demographics
NPI:1073297115
Name:ARCHIE, JANEISE T
Entity type:Individual
Prefix:
First Name:JANEISE
Middle Name:T
Last Name:ARCHIE
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 1:1430 K ST NW STE 800
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-2526
Mailing Address - Country:US
Mailing Address - Phone:202-873-2688
Mailing Address - Fax:
Practice Address - Street 1:1369 IRVING ST NW APT 304
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-7235
Practice Address - Country:US
Practice Address - Phone:202-702-6121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health