Provider Demographics
NPI:1265406409
Name:HARDING- ANDERER, TAMMY L (CRNP)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:L
Last Name:HARDING- ANDERER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:780 BROAD ST
Practice Address - Street 2:
Practice Address - City:MONTOURSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17754-2419
Practice Address - Country:US
Practice Address - Phone:570-368-2870
Practice Address - Fax:570-368-4463
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP003667B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S67286Medicare UPIN
PA021502Medicare ID - Type Unspecified