MRS. VIVIAN V TAN (NPI# 1649787011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649787011 |
| Entity Type | Individual |
| Full Name | MRS. VIVIAN V TAN |
| Other Name | MISS VIVIAN C VALDEZ |
| Credential | NP-C |
| Practice Address |
6480 Old Waterloo Rd Elkridge MD 21075 |
| Mailing Address |
6480 Old Waterloo Rd Elkridge MD 21075-6508 |
| Practice Telephone | 4107990291 |
| Mailing Telephone | 4107990291 |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-09-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R164835 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4155 Glen Park Rd, Nottingham, MD 212361019 | 4102480661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164603585 | Vivian L Tan | Pharmacist | 2155 3rd Ave, New York, NY 10035-4707 | 2007-11-14 |
| 1083748008 | Vivian Tan | Pathology | 513 Parnassus Ave, San Francisco, CA 94143-2205 | 2007-03-14 |
| 1093807679 | Vivian R. Tan | Internal Medicine | 1011 Baldwin Park Blvd, Baldwin Park, CA 91706-5806 | 2006-09-29 |
| 1013951425 | Vivian L Tan | Anesthesiology | 600 Coffee Rd, Modesto, CA 95355-4201 | 2006-06-15 |
| 1902847197 | Vivian C Tan | Radiology | 462 Grider St, Buffalo, NY 14215-3021 | 2006-06-09 |
| Street Address |
6480 OLD WATERLOO RD |
| City | ELKRIDGE |
| State | MD |
| Zip Code | 21075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457455305 | Maryland Cvs Pharmacy, L.L.C. | Pharmacy | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2006-09-12 |
| 1164036216 | Fabrice Djoukam | Pharmacist | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2020-09-05 |
| 1295373744 | Komal Patel | Family Medicine | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2019-12-16 |
| 1902455579 | Agil K Jose | Pharmacist | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2019-09-06 |
| 1851835078 | Hoang-anh Tran | Pharmacist | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2016-12-06 |
| 1841667698 | Stephanie Ann Jurkovic | Pharmacist | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2015-08-27 |
| 1376952192 | Elise Bogard | Pharmacist | 6480 Old Waterloo Rd, Elkridge, MD 21075 | 2014-08-06 |
| 1104234624 | Mary Casciano | Pharmacist | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2014-07-28 |
| 1336450220 | Olufemi Otubanjo | Physician Assistant | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2010-06-25 |
| 1134452733 | Traci Jean Hammel | Nurse Practitioner | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2009-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174043640 | Howard County Health Department | Clinic/Center | 6925 Old Waterloo Road, Hchd Deep Run Elementary School-based Wellness Center, Elkridge, MD 21075 | 2017-06-26 |
| 1023485539 | Cvs | Clinic/Center | 6480 Old Waterloo Road, Elkridge, MD 21075 | 2015-09-01 |
| 1063762417 | Mid-atlantic Allergy & Asthma | Clinic/Center | 8182 Lark Brown Road, Elkridge, MD 21075 | 2012-09-13 |
| 1447522925 | Alberta Osei Agyeman | Social Worker | 7274 Elkridge Crossing Way, Elkridge, MD 21075 | 2012-01-31 |
| 1588970552 | Mira M Patel | Pharmacist | 7270 Montgomery Road, Rite Aid Pharmacy, Elkridge, MD 21075 | 2010-08-27 |
| 1710298112 | Emily Jeanne Marti | Nurse Practitioner | 6095 Marshalee Drive, Elkridge, MD 21075 | 2010-06-30 |
| 1538352612 | Costco Wholesale Corp | Pharmacy | 6675 Marie Curie Dr, Elkridge, MD 21075 | 2007-08-22 |
| 1225250707 | Orthosport Physical Therapy of Md | Clinic/Center | 8174 Lark Brown Road, Suite 101, Elkridge, MD 21075 | 2007-05-03 |
| 1164643086 | Linda M. Jones-laper | Dentist | 6865 Deerpath Rd Suite 100, Elkridge, MD 21075 | 2007-05-01 |
| 1487756813 | Robert E Skillman Jr. | Dentist | 5921 Old Washington Rd, Elkridge, MD 21075 | 2006-09-05 |
| Find all providers in zip 21075 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417351255 | Angela Awuah | Nurse Practitioner | 6481 Abel St, Elkridge, MD 21075-5298 | 2014-10-21 |
| 1184053381 | Jane Choi | Nurse Practitioner | 7377 Washington Blvd Ste 101, Elkridge, MD 21075-6360 | 2013-11-07 |
| 1467516187 | Jennifer Elizabeth Ruddle-frey | Nurse Practitioner | 6085 Marshalee Dr, 110, Elkridge, MD 21075-6023 | 2006-12-20 |
| 1598857310 | Crystal Ann Morris | Nurse Practitioner | 6514 Meadowridge Rd, Elkridge, MD 21075-6115 | 2006-09-29 |
| 1255353736 | Rebecka Sue Harper | Nurse Practitioner | 6514 Meadow Ridge Rd, Elkridge, MD 21075-6115 | 2006-07-24 |
| 1083103428 | Effie Pinkrah | Nurse Practitioner | 6020 Meadowridge Center Dr, Elkridge, MD 21075-6528 | 2018-05-01 |
| 1013452549 | Mark Abbott | Nurse Practitioner | 6030 Marshalee Dr, #202, Elkridge, MD 21075 | 2016-12-19 |
| 1275077083 | Susane Njomo | Nurse Practitioner | 6095 Marshalee Dr, Elkridge, MD 21075-6053 | 2016-12-13 |
| 1235684325 | Traci Stokes | Nurse Practitioner | 6095 Marshalee Dr, Elkridge, MD 21075-6053 | 2016-08-18 |
| 1164879904 | Illya Payne | Nurse Practitioner | 6095 Marshalee Dr, Elkridge, MD 21075-6053 | 2016-05-23 |
| Find all providers in ELKRIDGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.