Provider Demographics
NPI:1598570624
Name:NEILL, TAMARA LYNN
Entity type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:LYNN
Last Name:NEILL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TAMMI
Other - Middle Name:LYNN
Other - Last Name:NEILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15608 COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136-3216
Mailing Address - Country:US
Mailing Address - Phone:402-599-0941
Mailing Address - Fax:
Practice Address - Street 1:15608 COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-3216
Practice Address - Country:US
Practice Address - Phone:402-599-0941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion