Provider Demographics
NPI:1386850667
Name:WARREN, TAMMIE (APRN, CPNP-AC/PC)
Entity Type:Individual
Prefix:MRS
First Name:TAMMIE
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:APRN, CPNP-AC/PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5503 WESTMINSTER DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2616
Mailing Address - Country:US
Mailing Address - Phone:512-534-6614
Mailing Address - Fax:
Practice Address - Street 1:1301 BARBARA JORDAN BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3077
Practice Address - Country:US
Practice Address - Phone:512-708-1234
Practice Address - Fax:512-708-4567
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX700730363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics