Provider Demographics
NPI:1710918453
Name:TAPPIN, LOLANDA (PA-C)
Entity type:Individual
Prefix:
First Name:LOLANDA
Middle Name:
Last Name:TAPPIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LOLANDA
Other - Middle Name:
Other - Last Name:TAPPIN-MOORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1901 E ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1901 E ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2528
Practice Address - Country:US
Practice Address - Phone:202-390-9058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002432363A00000X
DCPA30194363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQ64899Medicare UPIN
MDKR52N395Medicare ID - Type Unspecified