Basic Information
Provider Information
NPI: 1932139516
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HEMPHILL
FirstName: TARNISHA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNM
OtherOrganizationName:  
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Mailing Information
Address1: 1838 GREENE TREE RD
Address2: SUITE 380
City: PIKESVILLE
State: MD
PostalCode: 212086391
CountryCode: US
TelephoneNumber: 4104155577
FaxNumber: 4104156682
Practice Location
Address1: 301 SAINT PAUL PL
Address2: P.O.B. 501
City: BALTIMORE
State: MD
PostalCode: 212022102
CountryCode: US
TelephoneNumber: 4103475700
FaxNumber: 4103475744
Other Information
ProviderEnumerationDate: 07/03/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000XR143543MDY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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