MEDICARE: THERESA P TANGHERLINI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	0017136808	VA

General Provider Information

NPI Number	:	1801852355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA P TANGHERLINI

Provider Business Mailing Address
First Line	:	638 D ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002
Country	:	US
Telephone Number	:	202-546-2361
Fax Number	:

Provider Business Practice Location Address
First Line	:	6303 LITTLE RIVER TPKE #300
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22312
Country	:	US
Telephone Number	:	703-914-8989
Fax Number	:	703-914-5494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	07/08/2007

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Directions to “ THERESA P TANGHERLINI ” Practice Location

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