Provider Demographics
NPI:1285118125
Name:MCCAIN, JEANETTE RACHEL
Entity type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:RACHEL
Last Name:MCCAIN
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 1:5702 JEFFERSON HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:FAIRMOUNT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-1727
Mailing Address - Country:US
Mailing Address - Phone:202-644-2991
Mailing Address - Fax:
Practice Address - Street 1:1845 HARVARD ST NW APT 327
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2359
Practice Address - Country:US
Practice Address - Phone:202-468-4201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant