Provider Demographics
NPI:1669718722
Name:SEWELL, RASHAWN LATRESE
Entity type:Individual
Prefix:
First Name:RASHAWN
Middle Name:LATRESE
Last Name:SEWELL
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 1:939 WILMOT CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-5417
Mailing Address - Country:US
Mailing Address - Phone:443-414-2372
Mailing Address - Fax:
Practice Address - Street 1:939 WILMOT CT
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-5417
Practice Address - Country:US
Practice Address - Phone:443-414-2372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00105357376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide