Provider Demographics
NPI:1871670505
Name:NEWMAN, TAMI LYNN (LVN)
Entity Type:Individual
Prefix:MS
First Name:TAMI
Middle Name:LYNN
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CARSON ST
Mailing Address - Street 2:
Mailing Address - City:BORGER
Mailing Address - State:TX
Mailing Address - Zip Code:79007-7801
Mailing Address - Country:US
Mailing Address - Phone:806-274-5829
Mailing Address - Fax:
Practice Address - Street 1:612 MISSOURI ST
Practice Address - Street 2:
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-3754
Practice Address - Country:US
Practice Address - Phone:806-273-3832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX176337164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse