Provider Demographics
NPI:1265874655
Name:EARNEST, TAMMY LORRAINE (FNP-C)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LORRAINE
Last Name:EARNEST
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CARLANNA LAKE RD
Mailing Address - Street 2:STE 102
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-5611
Mailing Address - Country:US
Mailing Address - Phone:907-247-9355
Mailing Address - Fax:907-225-9376
Practice Address - Street 1:120 CARLANNA LAKE RD
Practice Address - Street 2:STE 102
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-5611
Practice Address - Country:US
Practice Address - Phone:907-247-9355
Practice Address - Fax:907-225-9376
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1383363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily