MEDICARE: TAMIKA BEARDEN APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WA2000X	Administrator Registered Nurse	726118	TX
2	363LF0000X	Family Nurse Practitioner	AP138744	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1P7402	OTHER	TX	MEDICARE
3	1P7386	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417445479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMIKA BEARDEN APRN, FNP-C

Provider Business Mailing Address
First Line	:	7109 FM 2920 RD STE 600
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2218
Country	:	US
Telephone Number	:	832-539-8898
Fax Number	:	832-539-8838

Provider Business Practice Location Address
First Line	:	7109 FM 2920 RD STE 600
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2218
Country	:	US
Telephone Number	:	832-539-8898
Fax Number	:	832-539-8838

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2018
Last Update Date	:	11/04/2021

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Directions to “ TAMIKA BEARDEN APRN, FNP-C” Practice Location

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