Provider Demographics
NPI:1184212185
Name:YOUNG, TAMMY LEE
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LEE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3664 LAKESTONE CIR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8100
Mailing Address - Country:US
Mailing Address - Phone:614-499-5240
Mailing Address - Fax:614-499-5240
Practice Address - Street 1:3664 LAKESTONE CIR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-8100
Practice Address - Country:US
Practice Address - Phone:614-499-5240
Practice Address - Fax:614-499-5240
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care