Provider Demographics
NPI:1972539096
Name:MCMEANS, TAMARA LEIGH (CRNA)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:LEIGH
Last Name:MCMEANS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:LEIGH
Other - Last Name:GRISHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 10005
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35631-2005
Mailing Address - Country:US
Mailing Address - Phone:256-768-9191
Mailing Address - Fax:256-768-9775
Practice Address - Street 1:201 AVALON AVE
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2805
Practice Address - Country:US
Practice Address - Phone:256-768-9191
Practice Address - Fax:256-768-9775
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-075814367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered