Provider Demographics
NPI:1619565538
Name:ATKINSON, TASHA-LEE ATKINSON
Entity Type:Individual
Prefix:
First Name:TASHA-LEE ATKINSON
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 E MOSHOLU PKWY N APT 1A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-3667
Mailing Address - Country:US
Mailing Address - Phone:347-485-9490
Mailing Address - Fax:
Practice Address - Street 1:239 E MOSHOLU PKWY N APT 1A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-3667
Practice Address - Country:US
Practice Address - Phone:347-485-9490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333120164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse