Provider Demographics
NPI:1952479024
Name:GRICE, TAMARA T (PA)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:T
Last Name:GRICE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:5901 WESTOWN PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8297
Mailing Address - Country:US
Mailing Address - Phone:515-221-9222
Mailing Address - Fax:515-221-9222
Practice Address - Street 1:5901 WESTOWN PKWY STE 210
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8297
Practice Address - Country:US
Practice Address - Phone:515-221-9222
Practice Address - Fax:515-221-9222
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA001684363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant