Individual
TAMATHA HENDERSON DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2480 LLEWELLYN AVE, FORT MEADE, MD 20755-5800
(301) 677-8270
(301) 677-8176
Mailing address
2480 LLEWELLYN AVE, FORT MEADE, MD 20755-5800
(301) 677-8270
(301) 677-8176
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000051016
TN
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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