Emilia Tabe

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN1002293 Issued in DC

Practice address

13201 Vandine St
Upper Marlboro, MD 20774-1827

Phone

(240) 381-0655

NPI assigned

May 16, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1588924112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 NEW YORK AVE NE",
            "address_2": "228",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200021848",
            "telephone_number": "202-832-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13201 VANDINE ST",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207741827",
            "telephone_number": "240-381-0655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1818 New York Ave NE",
            "address_2": "228",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200021848",
            "country_code": "US",
            "telephone_number": "202-832-8340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABE",
        "first_name": "EMILIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "DC",
            "license": "LPN1002293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Licensed Practical Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.