1154895183 NPI number — MRS. TALIA LYNN ROMANYSHYN NP-C

Table of content: MRS. TALIA LYNN ROMANYSHYN NP-C (NPI 1154895183)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154895183 NPI number — MRS. TALIA LYNN ROMANYSHYN NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROMANYSHYN
Provider First Name:
TALIA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154895183
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1110 E RIALTO AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93704-3314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-288-5082
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7780 N FRESNO ST STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93720-2413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-493-5760
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/12/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP2300X , with the licence number:  95010437 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 95010437 . This is a "STATE OF CALIFORNIA BOARD OF REGISTERED NURSING FURNISHING NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: F08180706 . This is a "AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com