Provider Demographics
NPI:1053484717
Name:TANTUM, JANE (RN)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:TANTUM
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:1703 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1082
Mailing Address - Country:US
Mailing Address - Phone:215-968-3655
Mailing Address - Fax:215-968-4830
Practice Address - Street 1:1703 LANGHORNE NEWTOWN RD
Practice Address - Street 2:SUITE 1
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1082
Practice Address - Country:US
Practice Address - Phone:215-968-3655
Practice Address - Fax:215-968-4830
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2010-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP000669B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA088273R5EMedicare ID - Type Unspecified
PAS43588Medicare UPIN