Provider Demographics
NPI:1962989491
Name:BOATWRIGHT, TANYA ELIZABETH (ARNP FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:ELIZABETH
Last Name:BOATWRIGHT
Suffix:
Gender:F
Credentials:ARNP FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1298 RE BYRD RD
Mailing Address - Street 2:
Mailing Address - City:FROSTPROOF
Mailing Address - State:FL
Mailing Address - Zip Code:33843-4618
Mailing Address - Country:US
Mailing Address - Phone:863-991-0751
Mailing Address - Fax:
Practice Address - Street 1:919 MALL RING RD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-8515
Practice Address - Country:US
Practice Address - Phone:863-382-2229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9294873207VG0400X, 207Q00000X
FLAPRN9294873363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine