Provider Demographics
NPI:1326816737
Name:BASKIN, TANDALENE APRIL (LPN)
Entity Type:Individual
Prefix:
First Name:TANDALENE
Middle Name:APRIL
Last Name:BASKIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 HERONS RUN DR APT 308
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-1743
Mailing Address - Country:US
Mailing Address - Phone:941-210-8129
Mailing Address - Fax:
Practice Address - Street 1:250 HERONS RUN DR APT 308
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-1743
Practice Address - Country:US
Practice Address - Phone:941-210-8129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5249740164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse