Provider Demographics
NPI:1003664483
Name:WEST -WARDRICK, LIZETTE UVONNA
Entity type:Individual
Prefix:
First Name:LIZETTE
Middle Name:UVONNA
Last Name:WEST -WARDRICK
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 1:700 12TH ST SE APT 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2960
Mailing Address - Country:US
Mailing Address - Phone:202-368-7159
Mailing Address - Fax:
Practice Address - Street 1:439 DELAFIELD PL NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-6112
Practice Address - Country:US
Practice Address - Phone:202-882-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant