Provider Demographics
NPI:1235830365
Name:QUARLES, TANJA MAKENZIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TANJA
Middle Name:MAKENZIE
Last Name:QUARLES
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HIGH TOWER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-1134
Mailing Address - Country:US
Mailing Address - Phone:412-214-0042
Mailing Address - Fax:
Practice Address - Street 1:100 HIGH TOWER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-1134
Practice Address - Country:US
Practice Address - Phone:412-214-0042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029914363LP0808X
WARN61174885163W00000X
MARN2325621163W00000X
WAAP61464829363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse