Provider Demographics
NPI:1932718681
Name:HERDMAN, TAMARA KAYE (REGISTERED NURSE/PUB)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:KAYE
Last Name:HERDMAN
Suffix:
Gender:F
Credentials:REGISTERED NURSE/PUB
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:KAYE
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 SOUTH MAIN STREET
Mailing Address - Street 2:STE#205
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901
Mailing Address - Country:US
Mailing Address - Phone:831-755-8410
Mailing Address - Fax:831-755-4438
Practice Address - Street 1:1000 SOUTH MAIN STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901
Practice Address - Country:US
Practice Address - Phone:831-755-8410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299558163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse