Provider Demographics
NPI:1679053722
Name:VARELA, TAMRA RENAE (FNP-C)
Entity Type:Individual
Prefix:
First Name:TAMRA
Middle Name:RENAE
Last Name:VARELA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:583 EL GUSTO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2519
Mailing Address - Country:US
Mailing Address - Phone:915-317-8657
Mailing Address - Fax:
Practice Address - Street 1:5055 MCNUTT RD
Practice Address - Street 2:
Practice Address - City:SANTA TERESA
Practice Address - State:NM
Practice Address - Zip Code:88008
Practice Address - Country:US
Practice Address - Phone:575-589-5005
Practice Address - Fax:575-589-1333
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138526363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily