Provider Demographics
NPI:1508146036
Name:NUNEZ, TAMMY SUE (RN BSN)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:SUE
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4380 W SENECA RD
Mailing Address - Street 2:LOT 119
Mailing Address - City:TRUMANSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14886-9533
Mailing Address - Country:US
Mailing Address - Phone:607-216-5640
Mailing Address - Fax:
Practice Address - Street 1:516 ELM ST
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:NY
Practice Address - Zip Code:13073-1124
Practice Address - Country:US
Practice Address - Phone:607-898-5853
Practice Address - Fax:607-898-5896
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22 556804163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool