Provider Demographics
NPI:1427891811
Name:DISTRICT WELLNESS SERVICES
Entity type:Organization
Organization Name:DISTRICT WELLNESS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNNJULIE
Authorized Official - Middle Name:AUGUSTINE
Authorized Official - Last Name:NKWABA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-498-8094
Mailing Address - Street 1:4523 ALABAMA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-4912
Mailing Address - Country:US
Mailing Address - Phone:202-255-2574
Mailing Address - Fax:
Practice Address - Street 1:4523 ALABAMA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-4912
Practice Address - Country:US
Practice Address - Phone:202-255-2574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Multi-Specialty