Provider Demographics
NPI:1649608027
Name:HARRIS, TAMARA LYNN (DNP, RN, FNP)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:LYNN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DNP, RN, FNP
Other - Prefix:MRS
Other - First Name:TAMARA
Other - Middle Name:LYNN
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, RN, FNP
Mailing Address - Street 1:320 RUSSELL BLVD
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1240
Mailing Address - Country:US
Mailing Address - Phone:936-569-6411
Mailing Address - Fax:936-569-6446
Practice Address - Street 1:320 RUSSELL BLVD
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1240
Practice Address - Country:US
Practice Address - Phone:936-585-1764
Practice Address - Fax:936-569-6446
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601946363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily