Provider Demographics
NPI:1760727002
Name:PARKER, TASHA W (CNM)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:W
Last Name:PARKER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:TASHA
Other - Middle Name:N
Other - Last Name:WASHINGTON-PARKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:2003 MEDICAL PKWY STE G50
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3067
Mailing Address - Country:US
Mailing Address - Phone:443-481-4400
Mailing Address - Fax:
Practice Address - Street 1:2003 MEDICAL PKWY STE G50
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3067
Practice Address - Country:US
Practice Address - Phone:443-481-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR195197367A00000X
367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID20004502Medicare PIN