Provider Demographics
NPI:1285398867
Name:TAZOH, ACHA COLLINS
Entity type:Individual
Prefix:
First Name:ACHA
Middle Name:COLLINS
Last Name:TAZOH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 BRIAN PLACE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020
Mailing Address - Country:US
Mailing Address - Phone:202-894-6811
Mailing Address - Fax:
Practice Address - Street 1:2800 BRIAN PLACE
Practice Address - Street 2:
Practice Address - City:WASHINGTON DC
Practice Address - State:DC
Practice Address - Zip Code:20020-5026
Practice Address - Country:US
Practice Address - Phone:240-470-9094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCHHA200001452OtherNURSING