Healthcare Provider Details

I. General information

NPI: 1417514571
Provider Name (Legal Business Name): TAMMY ANNETTE FLUKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 W PLEASANT RIDGE RD
ARLINGTON TX
76016-4427
US

IV. Provider business mailing address

5900 W PLEASANT RIDGE RD
ARLINGTON TX
76016-4427
US

V. Phone/Fax

Practice location:
  • Phone: 817-478-6041
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP140222
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP140222
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: