Individual
TAMMY LYNN UNDIEMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
810 SIXTH AVE, SANDPOINT, ID 83864-5396
(208) 263-3410
(208) 255-4842
Mailing address
810 SIXTH AVE, SANDPOINT, ID 83864-5396
(208) 263-3410
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
73671
ID
363LF0000X
Family Nurse Practitioner
73671
ID
Other
Enumeration date
05/04/2019
Last updated
06/30/2023
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