Provider Demographics
NPI:1518701846
Name:YOUNGER, EVELYN MATILDA
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:MATILDA
Last Name:YOUNGER
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 1:1211 NOVA AVE
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-4066
Mailing Address - Country:US
Mailing Address - Phone:202-360-8881
Mailing Address - Fax:
Practice Address - Street 1:6143 KANSAS AVE NE APT 3
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1558
Practice Address - Country:US
Practice Address - Phone:202-748-0654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant