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General NPI Number Information
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NPI Number | 1992533061
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Entity Type | Individual
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Provider Name | MEREDITH WOOD TANNER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 739 IRVING AVE STE 600
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City | SYRACUSE
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State | NY
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Zip | 13210-1663
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Country | US
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Telephone | 315-701-2550
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Fax | 315-701-2551
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Provider Business Mailing Address
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Address Line | 1001 W FAYETTE ST STE 400
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City | SYRACUSE
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State | NY
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Zip | 13204-2866
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Country | US
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Telephone | 315-937-3433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 354296
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License Number State | NY
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