Healthcare Provider Details

I. General information

NPI: 1811074149
Provider Name (Legal Business Name): TAMAR SPART RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 E KNOX RD
PHOENIX AZ
85044-4701
US

IV. Provider business mailing address

4201 E KNOX RD
PHOENIX AZ
85044-4701
US

V. Phone/Fax

Practice location:
  • Phone: 480-759-6125
  • Fax: 480-459-8458
Mailing address:
  • Phone: 480-759-6125
  • Fax: 480-459-8458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number053316
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: