Provider Demographics
NPI:1578251351
Name:SCHEPPELMAN, TAMARA KAY (RN)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:KAY
Last Name:SCHEPPELMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:KAY
Other - Last Name:KREINBRINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:122 ELWILL CT
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-1818
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:122 ELWILL CT
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-1818
Practice Address - Country:US
Practice Address - Phone:616-416-6443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704179583163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse