Provider Demographics
NPI:1124659651
Name:FORWARD, TAMI L
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:L
Last Name:FORWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 LAWMAN CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-4501
Mailing Address - Country:US
Mailing Address - Phone:818-606-1992
Mailing Address - Fax:
Practice Address - Street 1:1460 LAWMAN CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4501
Practice Address - Country:US
Practice Address - Phone:818-606-1992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant