Provider Demographics
NPI:1154895183
Name:ROMANYSHYN, TALIA LYNN (NP-C)
Entity type:Individual
Prefix:MRS
First Name:TALIA
Middle Name:LYNN
Last Name:ROMANYSHYN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 E RIALTO AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-3314
Mailing Address - Country:US
Mailing Address - Phone:559-288-5082
Mailing Address - Fax:
Practice Address - Street 1:7780 N FRESNO ST STE 100
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2413
Practice Address - Country:US
Practice Address - Phone:559-493-5760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-12
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010437363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95010437OtherSTATE OF CALIFORNIA BOARD OF REGISTERED NURSING FURNISHING NUMBER
F08180706OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD