Provider Demographics
NPI:1598131211
Name:PRIOR, TAMI LYNNETTE
Entity Type:Individual
Prefix:MS
First Name:TAMI
Middle Name:LYNNETTE
Last Name:PRIOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMI
Other - Middle Name:LYNNETTE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:10576 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-1220
Mailing Address - Country:US
Mailing Address - Phone:530-559-5362
Mailing Address - Fax:
Practice Address - Street 1:801 E WILLIAMS AVE # 3309
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-3052
Practice Address - Country:US
Practice Address - Phone:775-423-3151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001937363LF0000X
CA95002439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily