Provider Demographics
NPI:1558697052
Name:SHEALY, TAMMY WINN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:WINN
Last Name:SHEALY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 HIGHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596-7909
Mailing Address - Country:US
Mailing Address - Phone:919-795-8920
Mailing Address - Fax:
Practice Address - Street 1:2650 WARD BLVD
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-1619
Practice Address - Country:US
Practice Address - Phone:252-243-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20695183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist