Provider Demographics
NPI:1851904312
Name:WAIT, TANYA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:MARIE
Last Name:WAIT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:MARIE
Other - Last Name:NASCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:448 E 1ST ST STE 137
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-2867
Mailing Address - Country:US
Mailing Address - Phone:719-539-4510
Mailing Address - Fax:719-539-7197
Practice Address - Street 1:448 E 1ST ST STE 137
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-2867
Practice Address - Country:US
Practice Address - Phone:719-539-4510
Practice Address - Fax:719-539-7197
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1669174163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health