Black, Tamara Lynn

Black, Tamara Lynn is an individual health care provider with primary practice located at 420 W 15Th Ave , Emporia KS 66801-5367. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Black, Tamara Lynn can be contacted via phone (620) 342-4864.

Contact Information

Primary practice address
420 W 15Th Ave Emporia KS 66801-5367
Fax: (620) 343-3545
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 45728 Kansas

Profile Details

NPI number 1508896143
LBN Legal business name Black, Tamara Lynn
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Feb 2nd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508896143 NPPES
Kansas MEDICAID 200332630B

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