Provider Demographics
NPI:1295205094
Name:LANTZ, TAMMY HARRIS (RN)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:HARRIS
Last Name:LANTZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:TAMMY
Other - Middle Name:LYNN
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:201 CHARLESTON RD
Mailing Address - Street 2:
Mailing Address - City:SHARPSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16150-3303
Mailing Address - Country:US
Mailing Address - Phone:724-813-4124
Mailing Address - Fax:
Practice Address - Street 1:3676 NORTH HERMITAGE ROAD SUITE 6
Practice Address - Street 2:
Practice Address - City:TRANSFER
Practice Address - State:PA
Practice Address - Zip Code:16154-1852
Practice Address - Country:US
Practice Address - Phone:330-726-0700
Practice Address - Fax:330-726-1114
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN568603163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse