Provider Demographics
NPI:1255171559
Name:QUANT, TAMARA NICOLE (APRN)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:NICOLE
Last Name:QUANT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:NICOLE
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2886 EAGLE POINT RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-7219
Mailing Address - Country:US
Mailing Address - Phone:904-982-0038
Mailing Address - Fax:
Practice Address - Street 1:2886 EAGLE POINT RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-7219
Practice Address - Country:US
Practice Address - Phone:904-982-0038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-27
Last Update Date:2024-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11033853363LF0000X
FLRN9293821163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily