Provider Demographics
NPI:1528528189
Name:PERRY, ANGELA DENISE
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:DENISE
Last Name:PERRY
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 1:12713 LAMPTON LN
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5324
Mailing Address - Country:US
Mailing Address - Phone:202-459-1531
Mailing Address - Fax:
Practice Address - Street 1:12713 LAMPTON LN
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5324
Practice Address - Country:US
Practice Address - Phone:202-459-1531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide