Provider Demographics
NPI:1497098495
Name:SPOTTS, TAMMY MCPHERSON (RN)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:MCPHERSON
Last Name:SPOTTS
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 1:1100 SHIRLEY ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-1370
Mailing Address - Country:US
Mailing Address - Phone:803-252-1979
Mailing Address - Fax:
Practice Address - Street 1:1100 SHIRLEY ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-1370
Practice Address - Country:US
Practice Address - Phone:803-252-1979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37181163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health