Individual
TARA EILEEN HAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
3200 PROVIDENCE DR, ANCHORAGE, AK 99508-4615
(907) 212-5006
(907) 212-4896
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R168345-5
MN
363LN0000X
Neonatal Nurse Practitioner
Primary
104039
AK
363LN0005X
Critical Care Neonatal Nurse Practitioner
R 168345-5
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
04/26/2011
Last updated
10/29/2015
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