Healthcare Provider Details

I. General information

NPI: 1417319294
Provider Name (Legal Business Name): TAMMY V BIHM CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 N FIFTH ST
GALLUP NM
87301-5306
US

IV. Provider business mailing address

24222 MCNABB LN
DENHAM SPRINGS LA
70726-7007
US

V. Phone/Fax

Practice location:
  • Phone: 505-863-3828
  • Fax:
Mailing address:
  • Phone: 225-247-2253
  • Fax: 225-757-6035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number56291
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP08695
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: