Provider Demographics
NPI:1770671380
Name:TAMBOR, LINDA DIANNE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:DIANNE
Last Name:TAMBOR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 357173
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32635-7173
Mailing Address - Country:US
Mailing Address - Phone:352-377-3274
Mailing Address - Fax:
Practice Address - Street 1:V.A. MEDICAL CENTER: 1601 S.W. ARCHER ROAD
Practice Address - Street 2:GERIATRIC CLINIC
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1197
Practice Address - Country:US
Practice Address - Phone:352-376-1611
Practice Address - Fax:352-379-4158
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1375392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily