Provider Demographics
NPI:1760869382
Name:CHEATER, TAMARA BONSACK (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:BONSACK
Last Name:CHEATER
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:14 SCRIVNER DR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSHIP
Mailing Address - State:MD
Mailing Address - Zip Code:20758-9777
Mailing Address - Country:US
Mailing Address - Phone:443-758-7665
Mailing Address - Fax:
Practice Address - Street 1:995 N. PRINCE FREDERICK BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678
Practice Address - Country:US
Practice Address - Phone:443-351-3376
Practice Address - Fax:410-535-6574
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-04
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR157116363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily