Provider Demographics
NPI:1821772880
Name:BOOKER, TEARA QUANSHAIA
Entity Type:Individual
Prefix:
First Name:TEARA
Middle Name:QUANSHAIA
Last Name:BOOKER
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 1:10901 RHODE ISLAND AVE UNIT 1904
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-2518
Mailing Address - Country:US
Mailing Address - Phone:443-554-7968
Mailing Address - Fax:
Practice Address - Street 1:10901 RHODE ISLAND AVE UNIT 1904
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2518
Practice Address - Country:US
Practice Address - Phone:443-554-7968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula