Provider Demographics
NPI:1558548768
Name:CARNES, TAMMY SUE (LPN)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:SUE
Last Name:CARNES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1330
Mailing Address - Country:US
Mailing Address - Phone:740-562-9851
Mailing Address - Fax:740-297-8664
Practice Address - Street 1:951 GARDEN RD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1330
Practice Address - Country:US
Practice Address - Phone:740-562-9851
Practice Address - Fax:740-297-8664
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH116581164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse