MEDICARE: MRS. TAMMY THERESA HEDRICK A.R.N.P.

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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	ARNP2835832	FL
2	363LF0000X	Family Nurse Practitioner	APRN2835832	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1558369314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMMY THERESA HEDRICK A.R.N.P.

Provider Business Mailing Address
First Line	:	221 NE PARK ST
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972-2923
Country	:	US
Telephone Number	:	863-484-6020
Fax Number	:	863-484-6017

Provider Business Practice Location Address
First Line	:	221 NE PARK ST
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972-2923
Country	:	US
Telephone Number	:	863-484-6020
Fax Number	:	863-462-6017

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	04/22/2025

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