MRS. TAMARA KAY THORN CNP NPI 1053606152

NPI Information

NPI: 1053606152
Provider Name: MRS. TAMARA KAY THORN, CNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
5348 LAMME RD
MORAINE, OH
ZIP 45439
Phone: (937) 534-4600
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MRS. Tamara Kay Thorn, CNP is a psychiatric/mental health nurse practitioner in Moraine, OH with 13 years of experience. MRS. Tamara Kay Thorn, CNP NPI is 1053606152. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Graduation Year:2011

The provider's business location address is:

5348 LAMME RD
MORAINE, OH
ZIP 45439-215
Phone: (937) 534-4600
Fax: (937) 522-8799

The NPI 1053606152 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/16/2011 and was last updated on 11/17/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	APRN.CNP.12381	OHIO	Yes
2	363LP2300X	Nurse Practitioner	Primary Care	COA,12381-NP	OHIO	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0051257	MEDICAID	OHIO
2	H013688	OTHER	OHIO	MEDICARE - OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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