Healthcare Provider Details

I. General information

NPI: 1598815276
Provider Name (Legal Business Name): TAMMIE F CONAWAY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 LLEWELLYN AVE
FORT MEADE MD
20755-5800
US

IV. Provider business mailing address

2480 LLEWELLYN AVE
FORT GEORGE G MEADE MD
20755-7081
US

V. Phone/Fax

Practice location:
  • Phone: 301-677-8157
  • Fax:
Mailing address:
  • Phone: 443-255-0143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberR196615
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: