Provider Demographics
NPI:1164968038
Name:ASAAH, MIRIAM
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:ASAAH
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 1:1220 12TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3722
Mailing Address - Country:US
Mailing Address - Phone:202-846-6830
Mailing Address - Fax:
Practice Address - Street 1:920 MADISON ST NW APT 104
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-8214
Practice Address - Country:US
Practice Address - Phone:202-817-7015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-16
Last Update Date:2024-10-21
Deactivation Date:2024-10-01
Deactivation Code:
Reactivation Date:2024-10-21
Provider Licenses
StateLicense IDTaxonomies
374U00000X
DCRN1061136163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide