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NPI Code Detail

MEDICARE: TANZI TAYYAB FNP-BC

MEDICARE: TANZI TAYYAB FNP-BC
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
1363LF0000XFamily Nurse Practitioner0024174708VA

General Provider Information

NPI Number : 1881128809
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANZI TAYYAB FNP-BC
Provider Business Mailing Address
First Line : 20 PIDGEON HILL DR STE 203
Second Line :
City : STERLING
State : VA
Zip : 20165-6134
Country : US
Telephone Number : 571-934-8408
Fax Number : 571-386-1404
Provider Business Practice Location Address
First Line : 20 PIDGEON HILL DR STE 203
Second Line :
City : STERLING
State : VA
Zip : 20165-6134
Country : US
Telephone Number : 571-934-8408
Fax Number : 571-386-1404
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2017
Last Update Date : 04/17/2017

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