Provider Demographics
NPI:1740309186
Name:VERTREES, TAMBRA KNIPP (RN)
Entity type:Individual
Prefix:MRS
First Name:TAMBRA
Middle Name:KNIPP
Last Name:VERTREES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 COCHISE DR
Mailing Address - Street 2:
Mailing Address - City:BISBEE
Mailing Address - State:AZ
Mailing Address - Zip Code:85603-3013
Mailing Address - Country:US
Mailing Address - Phone:520-432-2309
Mailing Address - Fax:
Practice Address - Street 1:100 OLD DOUGLAS RD
Practice Address - Street 2:
Practice Address - City:BISBEE
Practice Address - State:AZ
Practice Address - Zip Code:85603-1038
Practice Address - Country:US
Practice Address - Phone:520-432-5391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN076821163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse