Provider Demographics
NPI:1265165724
Name:COTTON, TASHARA
Entity type:Individual
Prefix:MS
First Name:TASHARA
Middle Name:
Last Name:COTTON
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 1:11054 AUSTIN LN
Mailing Address - Street 2:
Mailing Address - City:WORTON
Mailing Address - State:MD
Mailing Address - Zip Code:21678-1950
Mailing Address - Country:US
Mailing Address - Phone:443-480-5321
Mailing Address - Fax:
Practice Address - Street 1:11054 AUSTIN LN
Practice Address - Street 2:
Practice Address - City:WORTON
Practice Address - State:MD
Practice Address - Zip Code:21678-1950
Practice Address - Country:US
Practice Address - Phone:443-480-5321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-02
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR243814163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator