Provider Demographics
NPI:1225442304
Name:ALLEN, TAMMY MICHELLE (RN)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:MICHELLE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 ARTISAN PKWY
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-6911
Mailing Address - Country:US
Mailing Address - Phone:502-649-2831
Mailing Address - Fax:
Practice Address - Street 1:910 ARTISAN PKWY
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-6911
Practice Address - Country:US
Practice Address - Phone:502-649-2831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1118508163W00000X
IN28212971A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse