Provider Demographics
NPI:1851672067
Name:BADER, TAMMY J (APRN)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:J
Last Name:BADER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:JEANNE
Other - Last Name:BADER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:7500 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2319
Mailing Address - Country:US
Mailing Address - Phone:855-524-4001
Mailing Address - Fax:402-398-5589
Practice Address - Street 1:7500 MERCY RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2319
Practice Address - Country:US
Practice Address - Phone:855-524-4001
Practice Address - Fax:402-398-5589
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000875207QH0002X
COC-APN.N0000875-C-N363LA2100X
IAL130515363LA2100X
NE111270363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty