Provider Demographics
NPI:1962152611
Name:FLEISCHHAUER, TAMEY DEONE (FNP)
Entity type:Individual
Prefix:
First Name:TAMEY
Middle Name:DEONE
Last Name:FLEISCHHAUER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 44TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-1324
Mailing Address - Country:US
Mailing Address - Phone:806-777-4837
Mailing Address - Fax:
Practice Address - Street 1:25 BRIERCROFT OFFICE PARK
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-3011
Practice Address - Country:US
Practice Address - Phone:806-795-7433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF10191001363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily