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Individual

TARITA BASANTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
3417 18TH ST NE, WASHINGTON, DC 20018-2721
(202) 629-2917
(202) 629-2797
Mailing address
2300 SKYLAND TER SE, WASHINGTON, DC 20020-3455
(240) 478-7164

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN1005714
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
030960869
DC
Enumeration date
02/15/2023
Last updated
02/15/2023
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