Provider Demographics
NPI:1871937482
Name:TAFIE, JOSEPHINE (CRNP)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:TAFIE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14280 BALTIMORE AVE STE 1026
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5006
Mailing Address - Country:US
Mailing Address - Phone:240-713-8080
Mailing Address - Fax:240-993-5700
Practice Address - Street 1:14300 CHERRY LANE CT STE 108
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4978
Practice Address - Country:US
Practice Address - Phone:240-713-8080
Practice Address - Fax:240-993-5700
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1025224363LF0000X, 363L00000X
MDR202692363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner