Provider Demographics
NPI:1427028893
Name:TOP, TAMARA J (CNP)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:J
Last Name:TOP
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:J
Other - Last Name:TOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-8000
Mailing Address - Fax:605-328-8001
Practice Address - Street 1:1309 W 17TH ST
Practice Address - Street 2:STE 101
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-8805
Practice Address - Country:US
Practice Address - Phone:605-328-8000
Practice Address - Fax:605-328-8001
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCNP 0366363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4993693OtherWELLMARK SD AND IA
SD01-25338OtherMEDICA
SD813T0DEOtherWELLMARK MINNESOTA
SD6001032Medicaid
SD9241672OtherDAKOTACARE
SD01-25338OtherMEDICA
SDP78879Medicare UPIN
SD9241672OtherDAKOTACARE