Provider Demographics
NPI:1275502601
Name:FELIX, TAMARA ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:ELIZABETH
Last Name:FELIX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6453 TAMBREN LN
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MN
Mailing Address - Zip Code:55779-9430
Mailing Address - Country:US
Mailing Address - Phone:218-729-4595
Mailing Address - Fax:
Practice Address - Street 1:6453 TAMBREN LN
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MN
Practice Address - Zip Code:55779-9430
Practice Address - Country:US
Practice Address - Phone:218-729-4595
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health