Provider Demographics
NPI:1992528673
Name:DILL, JUANITA
Entity type:Individual
Prefix:
First Name:JUANITA
Middle Name:
Last Name:DILL
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 1:300 L ST NE APT 605
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3575
Mailing Address - Country:US
Mailing Address - Phone:202-699-8401
Mailing Address - Fax:
Practice Address - Street 1:101 G ST SW APT A109
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-4305
Practice Address - Country:US
Practice Address - Phone:202-277-1873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant