Provider Demographics
NPI:1275928004
Name:VORONCHIKHINA, TATIANA (MSN, BA, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:VORONCHIKHINA
Suffix:
Gender:F
Credentials:MSN, BA, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9145 FOREST WIND DR
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-9390
Mailing Address - Country:US
Mailing Address - Phone:901-496-8282
Mailing Address - Fax:
Practice Address - Street 1:9145 FOREST WIND DR
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-9390
Practice Address - Country:US
Practice Address - Phone:901-496-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000180639163WM0102X
TN19839363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn