Doctor Name: | TAMMY LORRAINE EARNEST |
NPI Number: | 1265874655 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 1383 |
Business Practice Address: | 120 Carlanna Lake Rd Ste 102 Ketchikan, AK - 999015611 |
Business Phone Number: | 9072479355 |
Business Fax Number: | 9072259376 |
Mailing Address: | 120 Carlanna Lake Rd, Ste 102 KETCHIKAN |
State: | AK |
Postal Code: | 999015611 |
Phone Number: | 9072479355 |
Fax Number: | 9072259376 |
NPI Enumeration Date: | 07/25/2013 |
NPI Last Update Date: | 02/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1383 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |