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General NPI Number Information
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NPI Number | 1669144655
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Entity Type | Individual
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Provider Name | EVERTE TATSA
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Gender | Female
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Dates
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Enumeration Date | 09/29/2021
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 6816 ELBROOK RD
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City | LANHAM
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State | MD
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Zip | 20706-3728
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Country | US
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Telephone | 240-828-9728
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Fax |
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Provider Business Mailing Address
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Address Line | 9127 EDMONSTON TER APT 202
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City | GREENBELT
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State | MD
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Zip | 20770-4558
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Country | US
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Telephone | 202-940-3606
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | HHA200001346
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License Number State | DC
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