Provider Demographics
NPI:1174183073
Name:TAWIAH, DORIS (CRNP)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:TAWIAH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7671 MANDRAKE CT UNIT 222
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-7995
Mailing Address - Country:US
Mailing Address - Phone:347-208-7025
Mailing Address - Fax:
Practice Address - Street 1:8 DENTON PLZ
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-9501
Practice Address - Country:US
Practice Address - Phone:443-606-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR210471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily