Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | RN1033562 | DC |
NPI | 1013554195 |
---|---|
Provider Name | Maureen O Tabansi |
First Address | Bowie, MD 20715-2577 |
Second Address | Washington, DC 20037-1008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2019 |
Last Update Date | 07/12/2019 |