Provider Demographics
NPI:1265087175
Name:ARTZ, TAMMY A
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:A
Last Name:ARTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7084 SHIRE RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-3403
Mailing Address - Country:US
Mailing Address - Phone:702-875-6720
Mailing Address - Fax:
Practice Address - Street 1:7084 SHIRE RIDGE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-3403
Practice Address - Country:US
Practice Address - Phone:702-875-6720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider