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NPI Code Detail

MEDICARE: ANNALISE RENAE TANBERG

MEDICARE: ANNALISE RENAE TANBERG
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
1106S00000XBehavior TechnicianNC

General Provider Information

NPI Number : 1295602720
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNALISE RENAE TANBERG
Provider Business Mailing Address
First Line : 180 RYNAL DR
Second Line :
City : GARNER
State : NC
Zip : 27529-8615
Country : US
Telephone Number : 505-228-9294
Fax Number :
Provider Business Practice Location Address
First Line : 2802 NEW BIRCH DR
Second Line :
City : RALEIGH
State : NC
Zip : 27610-7000
Country : US
Telephone Number : 919-342-6047
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2025
Last Update Date : 10/20/2025

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Directions to “ ANNALISE RENAE TANBERG ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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