Glory Tataw, | |
3203a Corporate Ct, Ellicott City, MD 21042-2247 | |
(410) 205-2458 | |
Not Available |
Full Name | Glory Tataw |
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Gender | Female |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 3203a Corporate Ct, Ellicott City, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033782115 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | R222480 (Maryland) | Primary |
163WP0808X | Registered Nurse - Psychiatric/mental Health | R222480 (Maryland) | Secondary |
Entity Name | A Glorious Place Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043952880 PECOS PAC ID: 4587040456 Enrollment ID: O20220929001683 |
Entity Name | Holistic Health - Counseling & Coaching |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1295349652 PECOS PAC ID: 5496191181 Enrollment ID: O20240318000013 |
Mailing Address | Practice Location Address |
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Glory Tataw, 3203a Corporate Ct, Ellicott City, MD 21042-2247 Ph: (410) 696-2645 | Glory Tataw, 3203a Corporate Ct, Ellicott City, MD 21042-2247 Ph: (410) 205-2458 |
Susan Marie L'heureux, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3218 Greenway Dr, Ellicott City, MD 21042 Phone: 410-294-1062 | |
Mrs. Lisa Ann Uhl, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3691 Park Ave Ste 9, Ellicott City, MD 21043 Phone: 301-279-2779 | |
Ms. Helen Lesada-lasam Cruz, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2635 Kidwell Pl, Ellicott City, MD 21043 Phone: 410-504-2453 | |
Mrs. Elizabeth Whitfield, MSN, CRNP, MPH, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4390 Montgomery Rd, Ellicott City, MD 21043 Phone: 410-203-1700 | |
Dr. Adebola O Adeleye, DNP, APN-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4390 Montgomery Rd, Attn: Minuteclinic Credentialing 2100, Ellicott City, MD 21043 Phone: 410-203-1700 | |
Wafa Nachifa, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7668 Blueberry Hill Ln, Ellicott City, MD 21043 Phone: 240-517-1179 |