Provider Demographics
NPI:1326079195
Name:TASHLEIN, DEBRA ANN (APRN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:TASHLEIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 GOLF RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-2115
Mailing Address - Country:US
Mailing Address - Phone:203-545-4416
Mailing Address - Fax:
Practice Address - Street 1:71 BRADLEY RD UNIT 4
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2662
Practice Address - Country:US
Practice Address - Phone:203-545-4416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003158363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health