Individual
MRS. TAMI LYNNE KEPHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
4125 BRIARGATE BLVD, COLORADO SPRINGS, CO 80920-3490
(719) 305-9025
(719) 305-9026
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
110077
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07110075
—
CO
Enumeration date
04/17/2007
Last updated
07/22/2013
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