Provider Demographics
NPI:1588546519
Name:TANG, NATASHA TIAJEAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:TIAJEAN
Last Name:TANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W HAVEN CT
Mailing Address - Street 2:
Mailing Address - City:LUXEMBURG
Mailing Address - State:WI
Mailing Address - Zip Code:54217-1091
Mailing Address - Country:US
Mailing Address - Phone:262-622-2353
Mailing Address - Fax:
Practice Address - Street 1:4115 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-5400
Practice Address - Country:US
Practice Address - Phone:920-684-5016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI23094-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist