Provider Demographics
NPI:1508290339
Name:COST, TAMMY J (CNS)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:J
Last Name:COST
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 STRAIGHT ST STE 400
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-1069
Mailing Address - Country:US
Mailing Address - Phone:513-624-0999
Mailing Address - Fax:
Practice Address - Street 1:330 STRAIGHT ST STE 400
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-1069
Practice Address - Country:US
Practice Address - Phone:513-624-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12726-NS364SA2200X
OHCOA 16129-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0104506Medicaid
OHH324610Medicare PIN