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General NPI Number Information
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NPI Number | 1245591973
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Entity Type | Individual
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Provider Name | ANYINKENG LYDIA TAZI REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 05/29/2012
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 12003 PISCATAWAY RD
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City | CLINTON
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State | MD
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Zip | 20735-1168
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Country | US
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Telephone | 240-691-6835
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Fax |
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Provider Business Mailing Address
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Address Line | 12003 PISCATAWAY RD
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City | CLINTON
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State | MD
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Zip | 20735-1168
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Country | US
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Telephone | 240-691-6835
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R208066
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN1031555
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License Number State | DC
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NULL
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