Provider Demographics
NPI:1427417898
Name:VANDE KAMP, TAMMY (CNP)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:VANDE KAMP
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:JO
Other - Last Name:FROKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7600 S MINNESOTA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2988
Mailing Address - Country:US
Mailing Address - Phone:605-271-5441
Mailing Address - Fax:605-271-5277
Practice Address - Street 1:304 WEST SD HIGHWAY 38
Practice Address - Street 2:STE 126
Practice Address - City:HARTFORD
Practice Address - State:SD
Practice Address - Zip Code:57033-5703
Practice Address - Country:US
Practice Address - Phone:605-494-1500
Practice Address - Fax:605-494-1501
Is Sole Proprietor?:No
Enumeration Date:2016-02-15
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7416363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health