Provider Demographics
NPI:1972087955
Name:YEAGER, TAMARA ALISON (CRNP)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:ALISON
Last Name:YEAGER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:ALISON
Other - Last Name:MINNICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11110 MEDICAL CAMPUS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-6797
Mailing Address - Country:US
Mailing Address - Phone:301-714-4400
Mailing Address - Fax:301-714-4424
Practice Address - Street 1:11110 MEDICAL CAMPUS RD STE 200
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6797
Practice Address - Country:US
Practice Address - Phone:301-714-4400
Practice Address - Fax:301-714-4424
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR178009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily