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General NPI Number Information
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NPI Number | 1447070206
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Entity Type | Individual
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Provider Name | TAMARA SHAMUS
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Gender | Female
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 2201 RIDGEWOOD RD STE 400
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City | WYOMISSING
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State | PA
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Zip | 19610-1193
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Country | US
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Telephone | 610-378-9601
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N PARK RD APT 1462
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City | READING
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State | PA
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Zip | 19610-3072
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Country | US
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Telephone | 610-587-3025
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP030943
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License Number State | PA
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