Healthcare Provider Details

I. General information

NPI: 1316091317
Provider Name (Legal Business Name): ALICIA RENEE TOMLINSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4809 GREENBELT RD
COLLEGE PARK MD
20740-2001
US

IV. Provider business mailing address

2101 E JEFFERSON ST KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 301-441-9150
  • Fax: 301-441-3147
Mailing address:
  • Phone: 301-816-2424
  • Fax: 301-816-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberR138903
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: