Provider Demographics
NPI:1083216287
Name:CALL, TANYA RENEE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:RENEE
Last Name:CALL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:RENEE
Other - Last Name:RYDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:RR 3 BOX 244
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WV
Mailing Address - Zip Code:25541-9517
Mailing Address - Country:US
Mailing Address - Phone:304-654-2800
Mailing Address - Fax:
Practice Address - Street 1:940 4TH AVE STE 600
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-0065
Practice Address - Country:US
Practice Address - Phone:304-529-7004
Practice Address - Fax:304-529-7303
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV107016363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner