Provider Demographics
NPI:1790346898
Name:TANGREDI, ROBIN ANNE (MS FNP-C)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:ANNE
Last Name:TANGREDI
Suffix:
Gender:F
Credentials:MS FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 HAMMOCKS DR APT 206
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-4216
Mailing Address - Country:US
Mailing Address - Phone:315-200-2687
Mailing Address - Fax:
Practice Address - Street 1:3402 HAMMOCKS DR APT 206
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-4216
Practice Address - Country:US
Practice Address - Phone:315-200-2687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF344536-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily