Provider Demographics
NPI:1477083905
Name:TOLOSA-LEGAZPI, KAREN AQUINO (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:AQUINO
Last Name:TOLOSA-LEGAZPI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 JUTLAND RD
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2819
Mailing Address - Country:US
Mailing Address - Phone:301-933-0222
Mailing Address - Fax:
Practice Address - Street 1:10801 LOCKWOOD DR STE 210
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1563
Practice Address - Country:US
Practice Address - Phone:301-298-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1002826363LA2100X
MDR160120363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care