Individual
MARYANN TASONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5811 ATLANTIC BLVD UNIT 875811, JACKSONVILLE, FL 32207-2214
(770) 756-1151
Mailing address
5811 ATLANTIC BLVD UNIT 875811, JACKSONVILLE, FL 32207-2214
(770) 756-1151
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11005208
FL
Other
Enumeration date
06/06/2012
Last updated
05/22/2020
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