Provider Demographics
NPI:1063600708
Name:POYNTER, TAMARA M (NP)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:M
Last Name:POYNTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8333 NAAB RD STE 250
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1983
Mailing Address - Country:US
Mailing Address - Phone:317-396-1300
Mailing Address - Fax:317-870-2728
Practice Address - Street 1:8333 NAAB RD STE 250
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1983
Practice Address - Country:US
Practice Address - Phone:317-396-1300
Practice Address - Fax:317-870-2728
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71001175A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200330760Medicaid
IN000000322793OtherANTHEM
IN176470YMedicare PIN
P32292Medicare UPIN