Provider Demographics
NPI:1760623185
Name:ESCOURSE, TAMIKQUE VANE (FNP)
Entity Type:Individual
Prefix:MS
First Name:TAMIKQUE
Middle Name:VANE
Last Name:ESCOURSE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 CAPTAIN THOMAS BLVD UNIT 52
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-5802
Mailing Address - Country:US
Mailing Address - Phone:929-240-0985
Mailing Address - Fax:
Practice Address - Street 1:385 W MAIN ST
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-4357
Practice Address - Country:US
Practice Address - Phone:860-212-5040
Practice Address - Fax:860-545-3755
Is Sole Proprietor?:No
Enumeration Date:2009-03-14
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY33335747363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily