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Individual

PHILOMENE TATABONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4090 WARNER AVE, HYATTSVILLE, MD 20784-1929
(240) 906-7422
Mailing address
4090 WARNER AVE, HYATTSVILLE, MD 20784-1929
(240) 906-7422

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN200002783
DC

Other

Enumeration date
03/10/2025
Last updated
03/10/2025
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