Provider Demographics
NPI:1558369314
Name:HEDRICK, TAMMY THERESA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:THERESA
Last Name:HEDRICK
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 NE PARK ST
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-2923
Mailing Address - Country:US
Mailing Address - Phone:863-484-6020
Mailing Address - Fax:863-484-6017
Practice Address - Street 1:221 NE PARK ST
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-2923
Practice Address - Country:US
Practice Address - Phone:863-484-6020
Practice Address - Fax:863-462-6017
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2835832363LX0001X
FLAPRN2835832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271798100Medicaid
FLY0700WMedicare ID - Type Unspecified