Provider Demographics
NPI:1578132809
Name:TARAWALY, FRANCESS F
Entity Type:Individual
Prefix:
First Name:FRANCESS
Middle Name:F
Last Name:TARAWALY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 OLD LINE AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2207
Mailing Address - Country:US
Mailing Address - Phone:314-397-5898
Mailing Address - Fax:410-946-2010
Practice Address - Street 1:203 OLD LINE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2207
Practice Address - Country:US
Practice Address - Phone:314-397-5898
Practice Address - Fax:410-946-2010
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00162844376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide