Healthcare Provider Details

I. General information

NPI: 1730010943
Provider Name (Legal Business Name): TANSHA MORGAN NOTTINGHAM FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1617 N JAMES ST
ROME NY
13440-2852
US

IV. Provider business mailing address

111 HOSPITAL DR ATTN:CREDENTIALING
UTICA NY
13502-2517
US

V. Phone/Fax

Practice location:
  • Phone: 315-336-8260
  • Fax:
Mailing address:
  • Phone: 315-624-6101
  • Fax: 315-624-6744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number580431
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: