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NPI Code Detail

MEDICARE: TAMARA R CLOUSE NP-C

MEDICARE: TAMARA R CLOUSE NP-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
1363LF0000XFamily Nurse Practitioner111155NE

General Provider Information

NPI Number : 1699081208
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARA R CLOUSE NP-C
Provider Business Mailing Address
First Line : 601 W LEOTA ST
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-6525
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 210 MCNEEL LN
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-6290
Country : US
Telephone Number : 308-221-6262
Fax Number : 308-221-6261
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2010
Last Update Date : 04/10/2019

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Directions to “ TAMARA R CLOUSE NP-C” Practice Location

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