Provider Demographics
NPI:1902304611
Name:BROWN, TANESHA RENEE (APN, FNP-BC)
Entity type:Individual
Prefix:
First Name:TANESHA
Middle Name:RENEE
Last Name:BROWN
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 OLD YORK RD
Mailing Address - Street 2:
Mailing Address - City:RINGOES
Mailing Address - State:NJ
Mailing Address - Zip Code:08551-1038
Mailing Address - Country:US
Mailing Address - Phone:973-760-6924
Mailing Address - Fax:
Practice Address - Street 1:1016 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:RINGOES
Practice Address - State:NJ
Practice Address - Zip Code:08551-1038
Practice Address - Country:US
Practice Address - Phone:973-760-6924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-28
Last Update Date:2018-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00799000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily