Provider Demographics
NPI:1528486156
Name:WAMSLEY, TAMARA
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:WAMSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3542 WESTMINISTER CT
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691-3647
Mailing Address - Country:US
Mailing Address - Phone:727-492-1529
Mailing Address - Fax:
Practice Address - Street 1:3542 WESTMINISTER CT
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-3647
Practice Address - Country:US
Practice Address - Phone:727-492-1529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA21722251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health