Healthcare Provider Details

I. General information

NPI: 1558369314
Provider Name (Legal Business Name): TAMMY THERESA HEDRICK A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 NE PARK ST
OKEECHOBEE FL
34972-2923
US

IV. Provider business mailing address

221 NE PARK ST
OKEECHOBEE FL
34972-2923
US

V. Phone/Fax

Practice location:
  • Phone: 863-484-6020
  • Fax: 863-462-6017
Mailing address:
  • Phone: 863-484-6020
  • Fax: 863-484-6017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP2835832
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN2835832
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: