Basic Information
| Provider Information | |||||||||
| NPI: | 1588151591 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLE | ||||||||
| FirstName: | LLOYDETTE | ||||||||
| MiddleName: | VICTORIA | ||||||||
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| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9869 GOOD LUCK RD APT 1 | ||||||||
| Address2: | |||||||||
| City: | LANHAM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207063228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2409386869 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2512 24TH ST NE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200182126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028328340 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2018 | ||||||||
| LastUpdateDate: | 04/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 374U00000X | HHA13604 | DC | Y | Nursing Service Related Providers | Home Health Aide |
No ID Information.