Provider Demographics
NPI:1619755147
Name:ROBINSON, TANGELA LACHELLE (RN)
Entity Type:Individual
Prefix:MISS
First Name:TANGELA
Middle Name:LACHELLE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 LIMESTONE VALLEY DR APT D
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-3687
Mailing Address - Country:US
Mailing Address - Phone:443-281-3689
Mailing Address - Fax:
Practice Address - Street 1:321 LIMESTONE VALLEY DR APT D
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-3687
Practice Address - Country:US
Practice Address - Phone:443-281-3689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
MDR200706163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No171400000XOther Service ProvidersHealth & Wellness Coach