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General NPI Number Information
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NPI Number | 1720599046
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Entity Type | Individual
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Provider Name | TAMMY LIN HIEBER AGPCNP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2017
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Last Update Date | 10/12/2017
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Provider Practice Location Address
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Address Line | 9895 66TH WAY N
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City | PINELLAS PARK
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State | FL
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Zip | 33782-2941
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Country | US
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Telephone | 727-505-5616
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Fax |
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Provider Business Mailing Address
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Address Line | 9895 66TH WAY N
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City | PINELLAS PARK
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State | FL
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Zip | 33782-2941
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Country | US
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Telephone | 727-505-5616
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 9228271
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License Number State | FL
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