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General NPI Number Information
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NPI Number | 1265834485
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Entity Type | Individual
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Provider Name | TAMARA SIPE
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Gender | Female
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 12/19/2019
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Provider Practice Location Address
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Address Line | 16321 STILLWELL RD
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City | BONNER SPRINGS
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State | KS
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Zip | 66012
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Country | US
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Telephone | 913-669-3345
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Fax |
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Provider Business Mailing Address
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Address Line | 8440 WEA ST
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City | DE SOTO
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State | KS
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Zip | 66018-8378
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Country | US
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Telephone | 913-669-3345
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 2014028449
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 557437
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License Number State | KS
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