Provider Demographics
NPI:1700269776
Name:EWING, TAMMY T (APRN)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:T
Last Name:EWING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 NW 31ST ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-1401
Mailing Address - Country:US
Mailing Address - Phone:954-543-1888
Mailing Address - Fax:800-886-0864
Practice Address - Street 1:1250 E HALLANDALE BEACH BLVD PH 2
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4647
Practice Address - Country:US
Practice Address - Phone:954-543-1888
Practice Address - Fax:800-886-0864
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9306673363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily