Provider Demographics
NPI:1881128809
Name:TAYYAB, TANZI (FNP-BC)
Entity type:Individual
Prefix:
First Name:TANZI
Middle Name:
Last Name:TAYYAB
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PIDGEON HILL DR STE 203
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6134
Mailing Address - Country:US
Mailing Address - Phone:571-934-8408
Mailing Address - Fax:571-386-1404
Practice Address - Street 1:20 PIDGEON HILL DR STE 203
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6134
Practice Address - Country:US
Practice Address - Phone:571-934-8408
Practice Address - Fax:571-386-1404
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174708363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily