Provider Demographics
NPI:1508002122
Name:MONNETT, TAMMY ANN
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:ANN
Last Name:MONNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOME INSTEAD
Other - Middle Name:
Other - Last Name:SENIOR CARE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:130 N LAZY FOX DR
Mailing Address - Street 2:
Mailing Address - City:WICKENBURG
Mailing Address - State:AZ
Mailing Address - Zip Code:85390-1270
Mailing Address - Country:US
Mailing Address - Phone:928-231-5011
Mailing Address - Fax:
Practice Address - Street 1:130 N LAZY FOX DR
Practice Address - Street 2:
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-1270
Practice Address - Country:US
Practice Address - Phone:928-231-5011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor