Healthcare Provider Details

I. General information

NPI: 1902849938
Provider Name (Legal Business Name): TAMMIE MAE BLAIR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 02/06/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 PAGE MILL ROAD SUITE 103
PALO ALTO CA
94306
US

IV. Provider business mailing address

195 PAGE MILL RD STE 103
PALO ALTO CA
94306-2073
US

V. Phone/Fax

Practice location:
  • Phone: 888-731-8994
  • Fax:
Mailing address:
  • Phone: 888-731-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0024168949
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: