Individual
MRS. FATMATA TITY TARAWALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4390 MONTGOMERY RD, ELLICOTT CITY, MD 21043-6068
(410) 203-1700
(410) 203-1026
Mailing address
6903 GREENVALE PKWY, HYATTSVILLE, MD 20784-1538
(301) 772-0957
(301) 772-1628
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN50629
DC
363LF0000X
Family Nurse Practitioner
Primary
R091956
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029880400
—
DC
Enumeration date
09/21/2006
Last updated
07/16/2009
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