Provider Demographics
NPI:1174213862
Name:TANEV, NILDA (RN)
Entity type:Individual
Prefix:
First Name:NILDA
Middle Name:
Last Name:TANEV
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 1:708 NW 191ST PL
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3056
Mailing Address - Country:US
Mailing Address - Phone:206-249-6588
Mailing Address - Fax:206-374-3043
Practice Address - Street 1:103 NW 140TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98177-3910
Practice Address - Country:US
Practice Address - Phone:206-249-6588
Practice Address - Fax:206-374-3043
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN600046609163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse