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Individual

MRS. TAMARA JEANNE SETOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
7001 JOHNNYCAKE RD STE 101, BALTIMORE, MD 21244-2419
(410) 719-0063
Mailing address
7001 JOHNNYCAKE RD STE 101, BALTIMORE, MD 21244-2419
(410) 804-3919
(410) 719-6338

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R114538
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1992794051
GROUP NPI NUMBER
MD
Enumeration date
09/25/2012
Last updated
01/03/2013
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