MEDICARE: TANASHIA JATIA THOMAS DNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	202-503-3339	DC

General Provider Information

NPI Number	:	1669260964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANASHIA JATIA THOMAS DNP

Provider Business Mailing Address
First Line	:	11246 HANNAH WAY
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-1681
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 IRVING ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-3017
Country	:	US
Telephone Number	:	762-375-1308
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	01/14/2026

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