Provider Demographics
NPI:1689935769
Name:TAMANGWA, ANNA NONAH
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:NONAH
Last Name:TAMANGWA
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 1:6204 DOWER VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3710
Mailing Address - Country:US
Mailing Address - Phone:240-423-1667
Mailing Address - Fax:
Practice Address - Street 1:6204 DOWER VILLAGE LN
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-3710
Practice Address - Country:US
Practice Address - Phone:240-423-1667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide