Individual
TAMARA RENAY EVERHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15-1037 KIAWE DRIVE, KEAAU, HI 96749
(208) 818-9984
Mailing address
15-2714 PAHOA VILLAGE ROAN UNIT H1 BOX 235, PAHOA, HI 96778
(208) 818-9984
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10206
ID
Other
Enumeration date
11/26/2021
Last updated
11/26/2021
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