Provider Demographics
NPI:1114369998
Name:HOLCOMB, TAMMIE SUE (DNP, AGACNP-BC)
Entity Type:Individual
Prefix:DR
First Name:TAMMIE
Middle Name:SUE
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:DNP, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38320-1609
Mailing Address - Country:US
Mailing Address - Phone:731-213-2662
Mailing Address - Fax:731-213-2539
Practice Address - Street 1:190 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:TN
Practice Address - Zip Code:38320-1609
Practice Address - Country:US
Practice Address - Phone:731-213-2662
Practice Address - Fax:731-213-2539
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17923363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN17923OtherADVANCED PRACTICE NURSING LICENSE