Provider Demographics
NPI:1417445479
Name:BEARDEN, TAMIKA (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:
Last Name:BEARDEN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7109 FM 2920 RD STE 600
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2218
Mailing Address - Country:US
Mailing Address - Phone:832-539-8898
Mailing Address - Fax:832-539-8838
Practice Address - Street 1:7109 FM 2920 RD STE 600
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-2218
Practice Address - Country:US
Practice Address - Phone:832-539-8898
Practice Address - Fax:832-539-8838
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX726118163WA2000X
TXAP138744363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1P7402OtherMEDICARE
TX423952701Medicaid
TX1P7386OtherMEDICARE