Provider Demographics
NPI:1821295973
Name:CRAWFORD, TAMARA LYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:LYNN
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:LYNN
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4512 RIDGE CANYON DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3052
Mailing Address - Country:US
Mailing Address - Phone:210-781-4816
Mailing Address - Fax:
Practice Address - Street 1:3851 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH241758363LA2200X
TX745913163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health