Provider Demographics
NPI:1558517086
Name:GARDELL, TAMMY L (APRN-BC)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:L
Last Name:GARDELL
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 HARVARD ROAD
Mailing Address - Street 2:ATT: HSU
Mailing Address - City:SHIRLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01464
Mailing Address - Country:US
Mailing Address - Phone:978-425-4341
Mailing Address - Fax:
Practice Address - Street 1:104 HARVARD ROAD
Practice Address - Street 2:ATT: HSU
Practice Address - City:SHIRLEY
Practice Address - State:MA
Practice Address - Zip Code:01464
Practice Address - Country:US
Practice Address - Phone:978-425-4341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN207078363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health