Provider Demographics
NPI:1649639204
Name:TAMBE, RUTH EBANGHA A
Entity type:Individual
Prefix:
First Name:RUTH EBANGHA
Middle Name:A
Last Name:TAMBE
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 1:319 CARROLL AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4315
Mailing Address - Country:US
Mailing Address - Phone:240-898-8768
Mailing Address - Fax:
Practice Address - Street 1:4609 30TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-1316
Practice Address - Country:US
Practice Address - Phone:240-898-8768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-11
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN500009178163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse