Provider Demographics
NPI:1730475716
Name:ULANOWSKI, TANITHA MICHELLE (CRNA)
Entity Type:Individual
Prefix:
First Name:TANITHA
Middle Name:MICHELLE
Last Name:ULANOWSKI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1374
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33302-1374
Mailing Address - Country:US
Mailing Address - Phone:214-458-7284
Mailing Address - Fax:
Practice Address - Street 1:2606 GRANT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-2836
Practice Address - Country:US
Practice Address - Phone:713-227-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX718135367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered