Provider Demographics
NPI:1407062417
Name:TAPPIN, DYANNE M (MD)
Entity Type:Individual
Prefix:
First Name:DYANNE
Middle Name:M
Last Name:TAPPIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DYANNE
Other - Middle Name:
Other - Last Name:PHILLIPPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-8031
Mailing Address - Country:US
Mailing Address - Phone:860-679-7687
Mailing Address - Fax:860-679-0131
Practice Address - Street 1:263 FARMINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-8031
Practice Address - Country:US
Practice Address - Phone:860-679-7687
Practice Address - Fax:860-679-0131
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA243899207V00000X
CT075924207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ703895Medicaid