Healthcare Provider Details

I. General information

NPI: 1619390960
Provider Name (Legal Business Name): BRIGITTA TANZER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2014
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 UPPER RAGSDALE DR BLDG A
MONTEREY CA
93940-5736
US

IV. Provider business mailing address

100 WILSON RD STE 100
MONTEREY CA
93940-7885
US

V. Phone/Fax

Practice location:
  • Phone: 831-333-3040
  • Fax:
Mailing address:
  • Phone: 831-242-8301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-1891
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number23753
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: