Provider Demographics
NPI:1235396631
Name:PLANTAN, TAMMI W (LPA)
Entity Type:Individual
Prefix:MRS
First Name:TAMMI
Middle Name:W
Last Name:PLANTAN
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:MRS
Other - First Name:TAMMI
Other - Middle Name:W
Other - Last Name:PLANTAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:5624 YATES GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-4010
Mailing Address - Country:US
Mailing Address - Phone:704-231-6957
Mailing Address - Fax:
Practice Address - Street 1:5624 YATES GARDEN LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-4010
Practice Address - Country:US
Practice Address - Phone:704-231-6957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2301103T00000X, 103TC0700X
NC5005477363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical