Provider Demographics
NPI:1316599848
Name:JOSEPH, TANIA (RN, BSN, IBCLC)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 RALPH ELLISON WAY NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-3843
Mailing Address - Country:US
Mailing Address - Phone:518-836-6370
Mailing Address - Fax:
Practice Address - Street 1:2508 RALPH ELLISON WAY NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-3843
Practice Address - Country:US
Practice Address - Phone:518-836-6370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1022151163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant