Individual
MR. ISREAL JACOB TANNEHILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2480 LLEWELLYN AVE, FORT MEADE, MD 20755-7081
(301) 677-8882
Mailing address
1711 VERONICA WAY, SEVERN, MD 21144-1552
(202) 415-6536
(301) 498-7986
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN1019113
DC
Other
Enumeration date
05/28/2013
Last updated
08/18/2022
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