Individual
MRS. TAWANNA MARIE DEANGELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3601 ODONNELL ST, BALTIMORE, MD 21224-5238
(443) 324-0645
Mailing address
3601 ODONNELL ST, BALTIMORE, MD 21224-5238
(443) 324-0645
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R153735
MD
Other
Enumeration date
08/26/2009
Last updated
12/30/2010
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