Provider Demographics
NPI:1487983920
Name:TOWNSEND-COOK, TAMERA A (PA)
Entity type:Individual
Prefix:MS
First Name:TAMERA
Middle Name:A
Last Name:TOWNSEND-COOK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MISS
Other - First Name:TAMERA
Other - Middle Name:A
Other - Last Name:TOWNSEND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:3505 S MERCY RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-0440
Mailing Address - Country:US
Mailing Address - Phone:480-786-9100
Mailing Address - Fax:480-861-2780
Practice Address - Street 1:3505 S MERCY RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-0440
Practice Address - Country:US
Practice Address - Phone:480-786-9100
Practice Address - Fax:480-861-2780
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4514363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical