Provider Demographics
NPI:1013898816
Name:TIELMAN-FENELUS, BRETT PHILLIP
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:PHILLIP
Last Name:TIELMAN-FENELUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 I ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2725
Mailing Address - Country:US
Mailing Address - Phone:202-834-0413
Mailing Address - Fax:
Practice Address - Street 1:300 T ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1508
Practice Address - Country:US
Practice Address - Phone:202-834-0413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty