Individual provider · Type 1 NPI
Tanya Kidandi
Primary Care Nurse Practitioner · Fort Worth, TX
NPI number
1104294875
Active
Practice location
1325 Pennsylvania Ave Ste 560
Fort Worth, TX 76104-2152
Mailing address
2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Other practice locations
- 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 · (414) 649-6000
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 6586-33 (WI) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | 1030527 (TX) |
Primary Care Nurse Practitioner: Definition to come...
3 other providers at this address
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About NPI 1104294875
Tanya Kidandi's National Provider Identifier is 1104294875, issued on Sep 10, 2015. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Fort Worth, TX. The record was last updated on Oct 9, 2024.