Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 065360-23 | NH |
N | 363LA2100X | Nurse Practitioner - Acute Care | 065360-23 | NH |
N | 363LG0600X | Nurse Practitioner - Gerontology | 065360-23 | NH |
NPI | 1083218598 |
---|---|
Provider Name | Mrs. Tanis Jean Robinson |
First Address | Concord, NH 03301-2548 |
Second Address | Concord, NH 03301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2020 |
Last Update Date | 16/12/2020 |