Provider Demographics
NPI:1225633480
Name:BOCKMAN, TAMARA ANNE (PMHNP)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:ANNE
Last Name:BOCKMAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6897 PAIUTE AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:NIWOT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-7169
Mailing Address - Country:US
Mailing Address - Phone:303-652-4196
Mailing Address - Fax:
Practice Address - Street 1:6897 PAIUTE AVE STE 5
Practice Address - Street 2:
Practice Address - City:NIWOT
Practice Address - State:CO
Practice Address - Zip Code:80503-7169
Practice Address - Country:US
Practice Address - Phone:303-652-4196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996095-NP163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health