Provider Demographics
NPI:1811074149
Name:SPART, TAMAR (RN)
Entity type:Individual
Prefix:MS
First Name:TAMAR
Middle Name:
Last Name:SPART
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 E KNOX RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4701
Mailing Address - Country:US
Mailing Address - Phone:480-759-6125
Mailing Address - Fax:480-459-8458
Practice Address - Street 1:4201 E KNOX RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-4701
Practice Address - Country:US
Practice Address - Phone:480-759-6125
Practice Address - Fax:480-459-8458
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ053316163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool