Healthcare Provider Details
I. General information
NPI: 1083618318
Provider Name (Legal Business Name): TAMMY LEA VANOVER AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/31/2005
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 S UNIVERSITY AVE STE A13
LITTLE ROCK AR
72205-5342
US
IV. Provider business mailing address
500 S UNIVERSITY AVE STE A13
LITTLE ROCK AR
72205-5344
US
V. Phone/Fax
- Phone: 501-664-0337
- Fax: 501-664-8191
- Phone: 501-664-0337
- Fax: 501-664-8191
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | A106 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: