Healthcare Provider Details

I. General information

NPI: 1831729946
Provider Name (Legal Business Name): TAWANDA L TARPLEY-TEDDER CEO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2020
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12907 BUFFALO SPRINGS PL
MIDLOTHIAN VA
23112-6914
US

IV. Provider business mailing address

12907 BUFFALO SPRINGS PL
MIDLOTHIAN VA
23112-6914
US

V. Phone/Fax

Practice location:
  • Phone: 434-250-6273
  • Fax:
Mailing address:
  • Phone: 434-250-6273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: