Provider Demographics
NPI:1346262557
Name:HARPER, TAMARA ANNE (ARNP)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:ANNE
Last Name:HARPER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:ANNE
Other - Last Name:POE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 W CENTRAL AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042-2184
Mailing Address - Country:US
Mailing Address - Phone:316-321-2100
Mailing Address - Fax:316-321-0270
Practice Address - Street 1:700 W CENTRAL AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042-2184
Practice Address - Country:US
Practice Address - Phone:316-321-2100
Practice Address - Fax:316-321-0270
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45465363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS161103OtherBC/BS
KSQ01080Medicare UPIN
KS161103Medicare ID - Type Unspecified