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Individual
TAMMY LEE HADFIELD
Active
Individual
TAMMY LEE HADFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP634A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10000547560
REGENCE BLUE SHIELD
ID
01
—
8N682
BLUE CROSS OF IDAHO
ID
01
—
CS10595
STATE BOARD OF PHARMACY
ID
Enumeration date
09/14/2006
Last updated
03/21/2013
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