Provider Demographics
NPI:1528805306
Name:TANOS, GISEL TANI (APRN)
Entity type:Individual
Prefix:MRS
First Name:GISEL
Middle Name:TANI
Last Name:TANOS
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 1:26 WHEELER RD
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-3027
Mailing Address - Country:US
Mailing Address - Phone:860-986-3518
Mailing Address - Fax:
Practice Address - Street 1:26 WHEELER RD
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-3027
Practice Address - Country:US
Practice Address - Phone:860-986-3518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily