Provider Demographics
NPI:1679103790
Name:TARBUTTON, ANDREW (FNP-C)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:TARBUTTON
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:ANDY
Other - Middle Name:
Other - Last Name:TARBUTTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:366 ROYAL CIR
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-5792
Mailing Address - Country:US
Mailing Address - Phone:903-283-1861
Mailing Address - Fax:
Practice Address - Street 1:627 E LANE ST
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:TX
Practice Address - Zip Code:75783-2303
Practice Address - Country:US
Practice Address - Phone:903-283-1861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX779093163W00000X
TX1116466363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse