Provider Demographics
NPI:1104632736
Name:GEDDIE, TARSHA NICHOLE
Entity type:Individual
Prefix:
First Name:TARSHA
Middle Name:NICHOLE
Last Name:GEDDIE
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 1:8204 QUILL POINT DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4369
Mailing Address - Country:US
Mailing Address - Phone:240-482-7226
Mailing Address - Fax:
Practice Address - Street 1:8204 QUILL POINT DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4369
Practice Address - Country:US
Practice Address - Phone:240-482-7226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide