Provider Demographics
NPI:1235308891
Name:TANGWA, MARIANA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARIANA
Middle Name:
Last Name:TANGWA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:MARIANA
Other - Middle Name:
Other - Last Name:TANGWA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:5809 CHERRYWOOD LN APT 202
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-1298
Mailing Address - Country:US
Mailing Address - Phone:301-474-1145
Mailing Address - Fax:
Practice Address - Street 1:5809 CHERRYWOOD LANE
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-474-1145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP 43469164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse