Provider Demographics
NPI:1003569278
Name:DIKE, TAMMY S
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:S
Last Name:DIKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:S
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 393
Mailing Address - Street 2:
Mailing Address - City:MC COOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-0393
Mailing Address - Country:US
Mailing Address - Phone:308-737-0542
Mailing Address - Fax:
Practice Address - Street 1:1713 W 3RD ST
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-2122
Practice Address - Country:US
Practice Address - Phone:308-737-0542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider