Provider Demographics
NPI:1891510053
Name:BLALOCK, BRITTANY ANN
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANN
Last Name:BLALOCK
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 1:2106 HERRING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607-3720
Mailing Address - Country:US
Mailing Address - Phone:202-891-0235
Mailing Address - Fax:
Practice Address - Street 1:5661 3RD ST NE APT 216
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-2543
Practice Address - Country:US
Practice Address - Phone:202-290-1976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant