Individual
CONSTANCE AYUK TATAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3219 CORPORATE CT, ELLICOTT CITY, MD 21042-2247
(443) 929-1462
Mailing address
3219 CORPORATE CT, ELLICOTT CITY, MD 21042-2247
(443) 929-1462
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R198020
MD
Other
Enumeration date
03/30/2019
Last updated
07/11/2023
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