Individual
NABILA S TANAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
105 BAINES CT, CARY, NC 27511-6625
(919) 380-0964
Mailing address
115 LITTLEFORD LN, CARY, NC 27519-6907
(919) 601-7832
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2825
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01576
BLUE CROSS BLUE SHIELD ID
NC
01
—
2352174
AETNA HMO AND PPO ID#
NC
01
—
5662666
AETNA PPO ID#
NC
05
—
8953730
—
NC
Enumeration date
08/21/2006
Last updated
07/09/2007
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