Individual
TANYA DE LA VERGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1402 GRAND AVE, WASHINGTON, IN 47501
(812) 257-0383
(812) 257-7072
Mailing address
PO BOX 760, WASHINGTON, IN 47501-0760
(812) 254-7310
(812) 257-8062
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01082422A
IN
208000000X
Pediatrics Physician
29393
AL
Other
Enumeration date
01/11/2007
Last updated
04/20/2023
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