Healthcare Provider Details

I. General information

NPI: 1851672067
Provider Name (Legal Business Name): TAMMY J BADER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMMY JEANNE BADER APRN

II. Dates (important events)

Enumeration Date: 08/31/2011
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 N 162ND AVE STE 300
OMAHA NE
68118-2540
US

IV. Provider business mailing address

515 N 162ND AVE STE 300
OMAHA NE
68118-2540
US

V. Phone/Fax

Practice location:
  • Phone: 402-354-1200
  • Fax: 402-354-1205
Mailing address:
  • Phone: 402-354-1200
  • Fax: 402-354-1205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number0000875
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberL130515
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number111270
License Number StateNE
# 4
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberC-APN.N0000875-C-N
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number111270
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: