Provider Demographics
NPI:1487270807
Name:WILLIAMS, TAMMY MICHELLE (APN-FNP)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:MICHELLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11681 VOYAGER PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3862
Mailing Address - Country:US
Mailing Address - Phone:719-510-8057
Mailing Address - Fax:
Practice Address - Street 1:11681 VOYAGER PKWY STE 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3862
Practice Address - Country:US
Practice Address - Phone:719-510-6730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0995610-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily