Provider Demographics
NPI:1558761775
Name:LEVER, TANYA (MSN,PNP-PC)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:LEVER
Suffix:
Gender:F
Credentials:MSN,PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 FRANKLIN HEALTH COMMONS
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938
Mailing Address - Country:US
Mailing Address - Phone:207-778-0482
Mailing Address - Fax:
Practice Address - Street 1:181 FRANKLIN HEALTH COMMONS
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938
Practice Address - Country:US
Practice Address - Phone:207-778-0482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04932423208000000X
NH049324-23208000000X
MECNP171193363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics