Provider Demographics
NPI:1194128363
Name:CYPRIEN, PHEDRE
Entity type:Individual
Prefix:
First Name:PHEDRE
Middle Name:
Last Name:CYPRIEN
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 1:64 GALVESTON ST SW
Mailing Address - Street 2:APT 101 SW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:64 GALVESTON ST SW
Practice Address - Street 2:APT 101 SW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2031
Practice Address - Country:US
Practice Address - Phone:202-714-7214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide