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General NPI Number Information
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NPI Number | 1710849658
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Entity Type | Individual
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Provider Name | AMELIA TAN
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Gender | Female
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 179 HOSPITAL DR
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City | SPRUCE PINE
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State | NC
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Zip | 28777-3035
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Country | US
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Telephone | 828-765-0110
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Fax |
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Provider Business Mailing Address
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Address Line | 2188 MURRAY HILL RD APT 7
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City | CLEVELAND
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State | OH
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Zip | 44106-2672
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Country | US
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Telephone | 858-951-7198
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NC
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