Provider Demographics
NPI:1992468920
Name:NEUENSCHWANDER, TAMARA (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:
Last Name:NEUENSCHWANDER
Suffix:
Gender:F
Credentials:PMHNP
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 131812
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75713-1812
Mailing Address - Country:US
Mailing Address - Phone:459-573-5539
Mailing Address - Fax:
Practice Address - Street 1:3960 BROADWAY BLVD STE 232
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-2591
Practice Address - Country:US
Practice Address - Phone:459-573-5539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-17
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1130185363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health