Provider Demographics
NPI:1164902920
Name:RAGSDALE, TAMOYIA (PCS(LB), NPCS(LB))
Entity type:Individual
Prefix:
First Name:TAMOYIA
Middle Name:
Last Name:RAGSDALE
Suffix:
Gender:F
Credentials:PCS(LB), NPCS(LB)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12420 FLETCHERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4527
Mailing Address - Country:US
Mailing Address - Phone:301-276-1669
Mailing Address - Fax:
Practice Address - Street 1:12420 FLETCHERTOWN RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4527
Practice Address - Country:US
Practice Address - Phone:301-276-1669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD374J00000X, 374U00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No374J00000XNursing Service Related ProvidersDoula
No374U00000XNursing Service Related ProvidersHome Health Aide