Provider Demographics
NPI:1336714195
Name:PILLSBURY, TAMEIKA C (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:TAMEIKA
Middle Name:C
Last Name:PILLSBURY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17405 VIGILANTE VW
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-6990
Mailing Address - Country:US
Mailing Address - Phone:254-383-2901
Mailing Address - Fax:
Practice Address - Street 1:1401 W 17TH ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-1929
Practice Address - Country:US
Practice Address - Phone:719-544-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0996195363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily