Provider Demographics
NPI:1649045162
Name:READE, TARRELLE CREWS
Entity type:Individual
Prefix:MRS
First Name:TARRELLE
Middle Name:CREWS
Last Name:READE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TARRELLE
Other - Middle Name:CREWS
Other - Last Name:GARDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN
Mailing Address - Street 1:2011 SUGAR HILL DR N
Mailing Address - Street 2:
Mailing Address - City:CREEDMOOR
Mailing Address - State:NC
Mailing Address - Zip Code:27522-7247
Mailing Address - Country:US
Mailing Address - Phone:919-339-5705
Mailing Address - Fax:
Practice Address - Street 1:2011 SUGAR HILL DR N
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522-7247
Practice Address - Country:US
Practice Address - Phone:919-339-5705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC255569163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health