Provider Demographics
NPI:1154392702
Name:SAFFA, TAMME MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:TAMME
Middle Name:MARIE
Last Name:SAFFA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TAMME
Other - Middle Name:MARIE
Other - Last Name:SAFFA-GILCREASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:17599 S HWY 88
Mailing Address - Street 2:GLMHC
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-0801
Mailing Address - Country:US
Mailing Address - Phone:918-342-8161
Mailing Address - Fax:918-341-4245
Practice Address - Street 1:17599 S HWY 88
Practice Address - Street 2:GLMHC
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-0801
Practice Address - Country:US
Practice Address - Phone:918-342-8161
Practice Address - Fax:918-341-4245
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1033363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100088240BMedicaid