Tamara Johnson
Individual provider Active NPI Nurse's Aide · Broken Bow, NE
NPI 1679225445 · NPPES record last updated Jan 24, 2022
Key facts
- NPI
- 1679225445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- Practice address
- 323 N 7TH Ave
Broken Bow, NE 68822-1718 - Phone
- (308) 872-6821
- Fax
- (308) 872-2751
- NPI assigned
- Jan 24, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broken Bow Public Schools County of Custer School District 25 | Current |
Accepting new patients |
Locations
323 N 7th Ave
Broken Bow, NE 68822
Phone (308) 872-2475
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | Yes |
Addresses
Primary practice location
323 N 7TH Ave
Broken Bow, NE 68822-1718
Mailing address
323 N 7TH Ave
Broken Bow, NE 68822-1718
Phone (308) 872-6821
Other providers in Broken Bow, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.