Doctor Name: | MS. TRAMIA SQUIRE |
NPI Number: | 1972850568 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | R178657 |
Business Practice Address: | 623a Pulaski Hwy Joppa, MD - 210853914 |
Business Phone Number: | 4438656248 |
Business Fax Number: | |
Mailing Address: | 623a Pulaski Hwy, JOPPA |
State: | MD |
Postal Code: | 210853914 |
Phone Number: | 4438656248 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2012 |
NPI Last Update Date: | 01/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R178657 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |