Provider Demographics
NPI:1790412427
Name:MAY, TANYA
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 US HIGHWAY 158 W
Mailing Address - Street 2:
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379-8304
Mailing Address - Country:US
Mailing Address - Phone:336-694-9331
Mailing Address - Fax:336-694-7511
Practice Address - Street 1:439 US HIGHWAY 158 W
Practice Address - Street 2:
Practice Address - City:YANCEYVILLE
Practice Address - State:NC
Practice Address - Zip Code:27379-8304
Practice Address - Country:US
Practice Address - Phone:336-694-9331
Practice Address - Fax:336-694-7511
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY404237363LP0808X
NC5017125363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health