Healthcare Provider Details

I. General information

NPI: 1649670423
Provider Name (Legal Business Name): TAMARA B SHEARROW N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAMMY MARIE BREIDING

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W CORK ST UNIT 405
WINCHESTER VA
22601-3876
US

IV. Provider business mailing address

333 W CORK ST UNIT 405
WINCHESTER VA
22601-3876
US

V. Phone/Fax

Practice location:
  • Phone: 540-313-9200
  • Fax: 540-686-7287
Mailing address:
  • Phone: 540-313-9200
  • Fax: 540-686-7287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024172000
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0024172000
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number0024172000
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number0024172000
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: