Healthcare Provider Details

I. General information

NPI: 1710918453
Provider Name (Legal Business Name): LOLANDA TAPPIN P.A.-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LOLANDA TAPPIN-MOORE P.A.-C.

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 E ST SE
WASHINGTON DC
20003-2528
US

IV. Provider business mailing address

1901 E ST SE
WASHINGTON DC
20003-2528
US

V. Phone/Fax

Practice location:
  • Phone: 202-390-9058
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0002432
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA30194
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: