MEDICARE: ILIANNA MARIE TAPANES FNP

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
1	363LP2300X	Primary Care Nurse Practitioner	95020224	CA

General Provider Information

NPI Number	:	1790524833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ILIANNA MARIE TAPANES FNP

Provider Business Mailing Address
First Line	:	435 ARDEN AVE STE 460
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-1139
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 ARDEN AVE STE 460
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-1139
Country	:	US
Telephone Number	:	888-209-8874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	04/13/2026

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