Provider Demographics
NPI:1568815272
Name:CURRY, TASHA LYNNE (FNP)
Entity type:Individual
Prefix:
First Name:TASHA
Middle Name:LYNNE
Last Name:CURRY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19436 HOWELL DR STE A
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-6923
Mailing Address - Country:US
Mailing Address - Phone:315-786-2000
Mailing Address - Fax:315-755-6001
Practice Address - Street 1:19436 HOWELL DR STE A
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-6923
Practice Address - Country:US
Practice Address - Phone:315-786-2000
Practice Address - Fax:315-755-6001
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY660166163W00000X
NY340888363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04551135Medicaid