Provider Demographics
NPI:1861005506
Name:LENT, TANYA LEIGH (RN)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:LEIGH
Last Name:LENT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2686 SMITH HILL RD
Mailing Address - Street 2:
Mailing Address - City:WALWORTH
Mailing Address - State:NY
Mailing Address - Zip Code:14568-9710
Mailing Address - Country:US
Mailing Address - Phone:315-576-4387
Mailing Address - Fax:315-333-5191
Practice Address - Street 1:2686 SMITH HILL RD
Practice Address - Street 2:
Practice Address - City:WALWORTH
Practice Address - State:NY
Practice Address - Zip Code:14568-9710
Practice Address - Country:US
Practice Address - Phone:315-576-4387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY716536163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse