Provider Demographics
NPI:1245689900
Name:DUNCAN, TAWANDA (HEALTH ADMINISTRATOR)
Entity type:Individual
Prefix:MS
First Name:TAWANDA
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:HEALTH ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 N TRYON ST STE 350
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-2789
Mailing Address - Country:US
Mailing Address - Phone:704-780-3047
Mailing Address - Fax:980-430-5635
Practice Address - Street 1:1801 N TRYON ST STE 350
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-2789
Practice Address - Country:US
Practice Address - Phone:704-780-3047
Practice Address - Fax:980-430-5635
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8470783OtherDRIVERS LICENCSE