Provider Demographics
NPI:1356485296
Name:TASSONE, BARBARA LEE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LEE
Last Name:TASSONE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21 SUGAR TREE PL
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-3141
Mailing Address - Country:US
Mailing Address - Phone:410-666-0944
Mailing Address - Fax:443-849-2860
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:GBMC INTERVENTIONAL RADIOLOGY
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:443-849-2311
Practice Address - Fax:443-849-2860
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR040163363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP69697Medicare UPIN