Provider Demographics
NPI:1568162865
Name:MUWWAKKIL, TATJANA AMARUS (CNM, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:TATJANA
Middle Name:AMARUS
Last Name:MUWWAKKIL
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 S SANTA FE AVE APT 611
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90021-1364
Mailing Address - Country:US
Mailing Address - Phone:215-913-9768
Mailing Address - Fax:
Practice Address - Street 1:695 S SANTA FE AVE APT 611
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-1364
Practice Address - Country:US
Practice Address - Phone:215-913-9768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife