Provider Demographics
NPI:1922301613
Name:ANTON, INES INGRID TAGNE (NP)
Entity Type:Individual
Prefix:
First Name:INES INGRID
Middle Name:TAGNE
Last Name:ANTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:INES INGRID
Other - Middle Name:TAGNE
Other - Last Name:NKWENTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:11 WILBRAHAM RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-3161
Practice Address - Country:US
Practice Address - Phone:413-794-3710
Practice Address - Fax:413-794-9595
Is Sole Proprietor?:No
Enumeration Date:2010-12-17
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN261117363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily