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General NPI Number Information
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NPI Number | 1295156677
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Entity Type | Organization
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Legal Business Name | T@N RELIABLE
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Dates
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Enumeration Date | 01/02/2014
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Last Update Date | 01/02/2014
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Provider Practice Location Address
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Address Line | 7735 RIVERDALE RD APT 203
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City | NEW CARROLLTON
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State | MD
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Zip | 20784-3902
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Country | US
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Telephone | 240-492-9462
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Fax |
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Provider Business Mailing Address
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Address Line | 7735 RIVERDALE RD APT 203
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City | NEW CARROLLTON
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State | MD
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Zip | 20784-3902
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | AGNES NKENG
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Credential |
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Telephone | 202-716-9262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | DC
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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 |
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