Provider Demographics
NPI:1881144996
Name:TORTICILL, TAMI DAWN (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:DAWN
Last Name:TORTICILL
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8737 NE BOONE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2632
Mailing Address - Country:US
Mailing Address - Phone:816-589-0643
Mailing Address - Fax:
Practice Address - Street 1:8737 NE BOONE ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2632
Practice Address - Country:US
Practice Address - Phone:816-589-0643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016004348363LA2100X
KS53-77247-062363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care