Tawana Motes

Individual provider Active NPI Licensed Vocational Nurse · Fort Detrick, MD

NPI 1730416355 · NPPES record last updated Nov 4, 2009

Key facts

NPI
1730416355
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
223182 (TX)
Practice address
1425 Porter St
Fort Detrick, MD 21702-9211
Phone
(301) 619-4653
NPI assigned
Nov 4, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
223182TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 223182 TX Yes

Addresses

Primary practice location

1425 Porter St
Fort Detrick, MD 21702-9211

Mailing address

1425 Porter St
Fort Detrick, MD 21702-9211
Phone (301) 619-4653

Other providers in Fort Detrick, MD

All providers in Fort Detrick, MD · Licensed Vocational Nurse in Maryland

Sources for this page

Verify at the official NPI Registry.