Tamara Vestal, RN153164

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN153164 Issued in AZ

Practice address

101 Civic Center LN
Lake Havasu City, AZ 86403-5607

Phone

(928) 855-8185

NPI assigned

Sep 28, 2012

Last updated

Sep 28, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1639420789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 POPPY TRAIL DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864067827",
            "telephone_number": "928-208-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIVIC CENTER LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035607",
            "telephone_number": "928-855-8185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESTAL",
        "first_name": "TAMARA",
        "name_prefix": "Mrs.",
        "credential": "RN153164",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-28",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN153164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Van Wyk
• Lindsay Vanlaningham
• Vein Clinic of Lake Havasu
• Angela Veneroni, PT
• Veritas Healthcare PLLC
• Brooke Louise Vetter, O.D.
• Casandra Villafana, LMT
• Jade Marie Vinatieri, FNP-BC
• Vip IV & Medical Spa, LLC
• Nicholas Virden, P.T., DPT

• Registered Nurse in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.