Provider Demographics
NPI:1013576925
Name:KREEMER, TAMMY LOUISE (LPN)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LOUISE
Last Name:KREEMER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 AZALEA DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-1284
Mailing Address - Country:US
Mailing Address - Phone:614-804-4246
Mailing Address - Fax:
Practice Address - Street 1:1306 AZALEA DR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-1284
Practice Address - Country:US
Practice Address - Phone:614-804-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN093300164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse