Provider Demographics
NPI:1306387394
Name:GILBERT YOUNG, TANYA ANN (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:ANN
Last Name:GILBERT YOUNG
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:ANN
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:3010 GREAT OAK DR
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2719
Mailing Address - Country:US
Mailing Address - Phone:703-586-2550
Mailing Address - Fax:
Practice Address - Street 1:3010 GREAT OAK DR
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-2719
Practice Address - Country:US
Practice Address - Phone:703-586-2550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1014291163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse