Provider Demographics
NPI:1750020871
Name:HEATH, TANIA (NP)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:HEATH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:160 W CAMINO REAL # 1228
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5942
Mailing Address - Country:US
Mailing Address - Phone:505-718-1499
Mailing Address - Fax:240-663-5033
Practice Address - Street 1:2 WISCONSIN CIR
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-7003
Practice Address - Country:US
Practice Address - Phone:505-718-1499
Practice Address - Fax:240-663-5033
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR213907363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health