Provider Demographics
NPI:1881258416
Name:HOSTETLER, TAMMY E (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:E
Last Name:HOSTETLER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:ELAINE
Other - Last Name:ESHELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:16430 N SCOTTSDALE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1581
Mailing Address - Country:US
Mailing Address - Phone:602-266-7000
Mailing Address - Fax:602-646-8901
Practice Address - Street 1:15015 W BELL RD STE 101114
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3214
Practice Address - Country:US
Practice Address - Phone:623-269-4870
Practice Address - Fax:623-269-4871
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ224943363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health