Basic Information
| Provider Information | |||||||||
| NPI: | 1508855370 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BELZ | ||||||||
| FirstName: | TAMERA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1423 | ||||||||
| Address2: | 223 E 14TH SUITE 100 | ||||||||
| City: | HASTINGS | ||||||||
| State: | NE | ||||||||
| PostalCode: | 689021423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024632929 | ||||||||
| FaxNumber: | 4024632939 | ||||||||
| Practice Location | |||||||||
| Address1: | 223 E 14TH ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | HASTINGS | ||||||||
| State: | NE | ||||||||
| PostalCode: | 689013200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024632929 | ||||||||
| FaxNumber: | 4024632939 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 110360 | NE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.