Individual
TAMARA LYNN TRUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
606 W 2ND ST, ERIE, PA 16507-1111
(814) 451-6700
(814) 451-6767
Mailing address
606 W 2ND ST, ERIE, PA 16507-1111
(814) 451-6700
(814) 451-6767
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN336138L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1017835820001
PROMISE PROVIDER NUMBER
PA
Enumeration date
04/18/2007
Last updated
07/08/2007
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