Provider Demographics
NPI:1174502264
Name:ANDERSON, TAMMY LYNN (APRN-C, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:LYNN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:APRN-C, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 JOHNSTON RD
Mailing Address - Street 2:
Mailing Address - City:RANSOM CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79366-2509
Mailing Address - Country:US
Mailing Address - Phone:210-392-8512
Mailing Address - Fax:
Practice Address - Street 1:1 JOHNSTON RD
Practice Address - Street 2:
Practice Address - City:RANSOM CANYON
Practice Address - State:TX
Practice Address - Zip Code:79366-2509
Practice Address - Country:US
Practice Address - Phone:210-392-8512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5130990363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily