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Individual
TARYN JANE DEANTONIO
Active
Individual
TARYN JANE DEANTONIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN632596
PA
363LF0000X
Family Nurse Practitioner
Primary
SP020073
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1036187200001
—
PA
01
—
789203
MEDICARE
PA
Enumeration date
03/14/2019
Last updated
04/14/2022
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