Healthcare Provider Details

I. General information

NPI: 1912903410
Provider Name (Legal Business Name): TAMARA L LINK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 05/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 ASHVILLE AVE SUITE 20
CARY NC
27518-6118
US

IV. Provider business mailing address

218 ASHVILLE AVE SUTIE 20
CARY NC
27518-6118
US

V. Phone/Fax

Practice location:
  • Phone: 919-233-0410
  • Fax: 919-233-0872
Mailing address:
  • Phone: 919-233-0410
  • Fax: 919-233-0872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201923
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: