Healthcare Provider Details

I. General information

NPI: 1508721812
Provider Name (Legal Business Name): TAMARA LYNN CARDENAS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12134 THAXTON LN # A
APISON TN
37302-7596
US

IV. Provider business mailing address

12134 THAXTON LN # A
APISON TN
37302-7596
US

V. Phone/Fax

Practice location:
  • Phone: 559-288-8089
  • Fax:
Mailing address:
  • Phone: 559-288-8089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number40599
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: