Provider Demographics
NPI:1306098249
Name:OWENS, TAMMY D (NP)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:D
Last Name:OWENS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:531 FARBER LAKES DR STE 202
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5773
Mailing Address - Country:US
Mailing Address - Phone:716-633-1927
Mailing Address - Fax:
Practice Address - Street 1:531 FARBER LAKES DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14221-5773
Practice Address - Country:US
Practice Address - Phone:716-633-1927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283777164W00000X
NY402831363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse