MEDICARE: MRS. TANYA SUE ATKINSON RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	808820	CA
2	164X00000X	Licensed Vocational Nurse	VN213072	CA

General Provider Information

NPI Number	:	1437370814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TANYA SUE ATKINSON RN

Provider Business Mailing Address
First Line	:	6 KEYSTONE CT
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95973-7239
Country	:	US
Telephone Number	:	530-895-1174
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 BRENTWOOD DRIVE
Second Line	:
City	:	CHESTER
State	:	CA
Zip	:	96020-0737
Country	:	US
Telephone Number	:	530-258-2151
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	06/27/2012

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