Individual
MS. TANA H YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-A
Contact information
Practice address
2002 MEDICAL PKWY, SUITE 120, ANNAPOLIS, MD 21401-3046
(443) 481-5300
(443) 481-6705
Mailing address
PO BOX 64294, BALTIMORE, MD 21264-4294
(410) 280-6573
(410) 280-6515
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R162103
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006
CAREFIRST BCBS
DC
01
—
64282101
CAREFIRST BCBS
MD
01
—
P00347745
RR MEDICARE
MD
Enumeration date
07/26/2005
Last updated
10/18/2007
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