Provider Demographics
NPI:1992015994
Name:BUMPUS, TAMARA (NP-C)
Entity Type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:
Last Name:BUMPUS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1004
Mailing Address - Country:US
Mailing Address - Phone:419-255-7883
Mailing Address - Fax:419-255-6438
Practice Address - Street 1:313 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-1004
Practice Address - Country:US
Practice Address - Phone:419-255-7883
Practice Address - Fax:419-255-6438
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-09
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.11785-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily