Provider Demographics
NPI:1659668739
Name:DAVIES FUHRER, TAMERA (LPN)
Entity Type:Individual
Prefix:
First Name:TAMERA
Middle Name:
Last Name:DAVIES FUHRER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 W DEAN AVE
Mailing Address - Street 2:
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53716-1009
Mailing Address - Country:US
Mailing Address - Phone:608-843-0456
Mailing Address - Fax:
Practice Address - Street 1:4413 AMERICAN ASH DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-1169
Practice Address - Country:US
Practice Address - Phone:608-334-8011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI305369-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse