Provider Demographics
NPI:1699939389
Name:YOUMANS, WILLIE LEE JR
Entity type:Individual
Prefix:
First Name:WILLIE
Middle Name:LEE
Last Name:YOUMANS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 EDGEWOOD ST NE APT 209
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-3316
Mailing Address - Country:US
Mailing Address - Phone:202-276-6230
Mailing Address - Fax:
Practice Address - Street 1:601 EDGEWOOD ST NE APT 209
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-3316
Practice Address - Country:US
Practice Address - Phone:202-276-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC0000000NOT SURE163W00000X
MDR161391163W00000X
VA0001163547163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse