Healthcare Provider Details

I. General information

NPI: 1437432390
Provider Name (Legal Business Name): TANYA M VAUGHN DENEEN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 6TH AVE STE 114
YORK PA
17403-2627
US

IV. Provider business mailing address

1600 6TH AVE STE 114
YORK PA
17403-2627
US

V. Phone/Fax

Practice location:
  • Phone: 717-845-9639
  • Fax: 717-699-1300
Mailing address:
  • Phone: 717-845-9639
  • Fax: 717-699-1300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number4704257240
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW010725
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN11012747
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW010725
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: