Healthcare Provider Details

I. General information

NPI: 1851714240
Provider Name (Legal Business Name): TONYA LAMBERT APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2014
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PHYSICIANS DR
SELMER TN
38375-1887
US

IV. Provider business mailing address

67 HARRIS DR
BETHEL SPRINGS TN
38315-3524
US

V. Phone/Fax

Practice location:
  • Phone: 731-645-6777
  • Fax:
Mailing address:
  • Phone: 731-610-1457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18716
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: