Provider Demographics
NPI:1710082888
Name:CABRERA, TAMMY ELAINE (APRN, BC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:ELAINE
Last Name:CABRERA
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:ELAINE
Other - Last Name:GODFREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, BC
Mailing Address - Street 1:2010 SAINT IVES BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6498
Mailing Address - Country:US
Mailing Address - Phone:865-693-1817
Mailing Address - Fax:
Practice Address - Street 1:2010 SAINT IVES BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-6498
Practice Address - Country:US
Practice Address - Phone:865-693-1817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000012136363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily