Provider Demographics
NPI:1730417593
Name:TAM HEALTHCARE OPTIONS, PLLC.
Entity type:Organization
Organization Name:TAM HEALTHCARE OPTIONS, PLLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CONTINA
Authorized Official - Middle Name:ANGELENE
Authorized Official - Last Name:MCCLAIN-PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:502-299-1827
Mailing Address - Street 1:5407 GALAXIE DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3329
Mailing Address - Country:US
Mailing Address - Phone:502-299-1827
Mailing Address - Fax:
Practice Address - Street 1:1904 CRUMS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-4228
Practice Address - Country:US
Practice Address - Phone:502-299-1827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-05
Last Update Date:2009-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4354363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty