Provider Demographics
NPI:1225033566
Name:BINDER, TAMERA R (PA-C)
Entity Type:Individual
Prefix:
First Name:TAMERA
Middle Name:R
Last Name:BINDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH SIOUX CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68776-1703
Mailing Address - Country:US
Mailing Address - Phone:402-494-3064
Mailing Address - Fax:
Practice Address - Street 1:501 1ST AVE
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-1703
Practice Address - Country:US
Practice Address - Phone:402-494-3064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3163363A00000X
NE537363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ935760Medicaid
AZR81675Medicare UPIN
AZ273108Medicare ID - Type Unspecified