Individual
TANA BAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN FNP-BC NP-C APRN
Contact information
Practice address
1275 ELM ST STE D, WEST SPRINGFIELD, MA 01089-1818
(508) 433-3687
(508) 283-1414
Mailing address
1275 ELM ST STE D, WEST SPRINGFIELD, MA 01089-1818
(508) 433-3687
(508) 283-1414
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2308657
MA
Other
Enumeration date
10/25/2019
Last updated
04/17/2023
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