Provider Demographics
NPI:1902691140
Name:HOWARD-BOONE, TANIQUE SHAYAN (BSN, RN, RNC-NIC)
Entity type:Individual
Prefix:
First Name:TANIQUE
Middle Name:SHAYAN
Last Name:HOWARD-BOONE
Suffix:
Gender:
Credentials:BSN, RN, RNC-NIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SKYLARK CT
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31793-8366
Mailing Address - Country:US
Mailing Address - Phone:229-457-0691
Mailing Address - Fax:
Practice Address - Street 1:3 SKYLARK CT
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31793-8366
Practice Address - Country:US
Practice Address - Phone:229-457-0691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN295718163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care