Provider Demographics
NPI:1225879018
Name:TAMMI BANCROFT PC
Entity type:Organization
Organization Name:TAMMI BANCROFT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMI
Authorized Official - Middle Name:
Authorized Official - Last Name:BANCROFT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C, PMHNP- BC
Authorized Official - Phone:303-630-9177
Mailing Address - Street 1:7661 MCLAUGHLIN RD # 1035
Mailing Address - Street 2:
Mailing Address - City:FALCON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-4727
Mailing Address - Country:US
Mailing Address - Phone:303-630-9177
Mailing Address - Fax:
Practice Address - Street 1:9602 FAIRWAY GLEN DR
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-4613
Practice Address - Country:US
Practice Address - Phone:303-630-9177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty