BRENDALYNE FACIA TAMBA (NPI# 1053925107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053925107 |
| Entity Type | Individual |
| Full Name | BRENDALYNE FACIA TAMBA |
| Credential | FNP |
| Practice Address |
361 Resource Pkwy Winder GA 30680-8364 |
| Mailing Address |
788 Heritage Lake Way Grayson GA 30017-7838 |
| Practice Telephone | 7702910419 |
| Practice Fax Number | 2403488500 |
| Mailing Telephone | 6783828005 |
| Enumeration Date | 2020-09-06 |
| Last Update Date | 2020-09-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN207407 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
361 RESOURCE PKWY |
| City | WINDER |
| State | GA |
| Zip Code | 30680-8364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659919066 | Ivydale Wellness Center | General Practice | 361 Resource Pkwy, Winder, GA 30680-8364 | 2019-12-16 |
| 1326653783 | Ivydale Wellness Center LLC | Clinic/Center | 361 Resource Pkwy, Winder, GA 30680-8364 | 2020-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326520776 | Alexandrea Hosch | Specialist/Technologist | 474 Lisa Circle, Winder, GA 30680 | 2018-09-02 |
| 1427574185 | Kristen Layfield Harbin | Dietitian, Registered | 827 Jefferson Hwy, Winder, GA 30680 | 2017-08-15 |
| 1417485715 | Staci Harwell Tebbetts | Optometrist | 279 N Broad St Ste C, Winder, GA 30680 | 2017-05-31 |
| 1609234947 | Carmichaels Home Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 289 N Broad St, Winder, GA 30680 | 2016-02-02 |
| 1699140434 | Chee Vang | Physical Therapy Assistant | 1012 Bowman Way, Winder, GA 30680 | 2015-12-04 |
| 1518361989 | Usrc Winder, LLC | Clinic/Center | 429 Loganville Hwy Ste 105-109, Winder, GA 30680 | 2014-10-14 |
| 1871901090 | Carol Lumpkin | Nurse Practitioner | 15 Porter St East, Winder, GA 30680 | 2014-07-31 |
| 1548501851 | Jennifer Won | Dentist | 444 Atlanta Hwy Nw Ste 500, Winder, GA 30680 | 2013-03-12 |
| 1801041595 | Joan Theresa James | Obstetrics & Gynecology | 137 W Athens St Ste 103, Winder, GA 30680 | 2008-11-21 |
| 1669636767 | Lee Lindsey Bleshoy | Nurse Practitioner | 133 W Athens St Ste A, Winder, GA 30680 | 2008-07-17 |
| Find all providers in zip 30680 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699278705 | Olga Kukharchuk | Nurse Practitioner | 682 Massey St, Winder, GA 30680-5642 | 2018-03-14 |
| 1710255997 | Seth Lee | Nurse Practitioner | 289 Woodland Dr, Winder, GA 30680-2426 | 2011-12-02 |
| 1669636767 | Lee Lindsey Bleshoy | Nurse Practitioner | 133 W Athens St Ste A, Winder, GA 30680 | 2008-07-17 |
| 1770678567 | Kathleen Ann Lloyd | Nurse Practitioner | 122 W Athens St, Winder, GA 30680-1707 | 2006-10-04 |
| 1902423841 | Nicole Reinecke Powell | Nurse Practitioner | 133 W Athens St, Winder, GA 30680-1786 | 2020-06-26 |
| 1942763636 | Courtney M Henson Corbett | Nurse Practitioner | 24 Amherst Dr, Winder, GA 30680-7463 | 2019-04-09 |
| 1023599404 | Ronald James Mirenda | Nurse Practitioner | 299 N Broad St, Winder, GA 30680 | 2018-08-24 |
| 1750734323 | Nelda Darlene Holley | Nurse Practitioner | 316 N Broad St, Winder, GA 30680-2150 | 2016-07-19 |
| 1710358502 | Stephanie Kutchback | Nurse Practitioner | 30 Satellite Dr, Winder, GA 30680-6211 | 2015-10-19 |
| 1386024636 | Bryan Stephens | Nurse Practitioner | 133 W Athens St, Winder, GA 30680-1786 | 2015-06-02 |
| Find all providers in WINDER | ||||
Please comment or provide details below to improve the information on BRENDALYNE FACIA TAMBA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.