Provider Demographics
NPI:1982353587
Name:EDWARDS, TAIMECKA
Entity type:Individual
Prefix:
First Name:TAIMECKA
Middle Name:
Last Name:EDWARDS
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 1:3109 75TH AVE APT 402
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-6911
Mailing Address - Country:US
Mailing Address - Phone:202-367-0369
Mailing Address - Fax:
Practice Address - Street 1:2412 AINGER PL SE APT 116
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3575
Practice Address - Country:US
Practice Address - Phone:202-597-6944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide