Provider Demographics
NPI:1659773034
Name:TASHKO, CORTNEY (FNP-C)
Entity Type:Individual
Prefix:
First Name:CORTNEY
Middle Name:
Last Name:TASHKO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15204 OMEGA DR STE 240
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4841
Mailing Address - Country:US
Mailing Address - Phone:301-658-3586
Mailing Address - Fax:
Practice Address - Street 1:15204 OMEGA DR STE 240
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4601
Practice Address - Country:US
Practice Address - Phone:301-658-3586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR184632363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD399290Medicare PIN
DC399279Medicare PIN