Provider Demographics
NPI:1215010509
Name:BLAND, TAMARA B (MSN, RN, CPNP)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:B
Last Name:BLAND
Suffix:
Gender:F
Credentials:MSN, RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 VOLUNTEER BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996-4515
Mailing Address - Country:US
Mailing Address - Phone:865-594-5078
Mailing Address - Fax:865-594-3921
Practice Address - Street 1:220 LANGLAND ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37915-1415
Practice Address - Country:US
Practice Address - Phone:865-594-5078
Practice Address - Fax:865-594-3921
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6885363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
6885OtherAPN NUMBER