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NPI Code Detail

MEDICARE: TAMARA R TRIPP NP

MEDICARE: TAMARA R TRIPP NP
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
1363L00000XNurse Practitioner600029NC

General Provider Information

NPI Number : 1710950381
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARA R TRIPP NP
Provider Business Mailing Address
First Line : PO BOX 2352
Second Line :
City : DAVIDSON
State : NC
Zip : 28036
Country : US
Telephone Number : 704-941-1866
Fax Number : 704-896-8672
Provider Business Practice Location Address
First Line : 3803 N ELM ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27455-2593
Country : US
Telephone Number : 704-941-1866
Fax Number : 336-540-6049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 01/01/2010

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