Provider Demographics
NPI:1396383238
Name:MCCASKILL, TANYA K (MSN, FNP)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:K
Last Name:MCCASKILL
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:MRS
Other - First Name:TANYA
Other - Middle Name:K
Other - Last Name:MCCASKILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3385 AIRWAYS BLVD STE 219
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116-3808
Mailing Address - Country:US
Mailing Address - Phone:901-205-9534
Mailing Address - Fax:833-471-4041
Practice Address - Street 1:3385 AIRWAYS BLVD STE 219
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-3808
Practice Address - Country:US
Practice Address - Phone:901-205-9534
Practice Address - Fax:833-471-4041
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX874022163WA2000X
TX1049939363LF0000X
MS904810363LF0000X
TN30082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator