Provider Demographics
NPI:1568879666
Name:VANSTOCKUM, TAMMY (RNC, BSN, CD(DONA))
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:VANSTOCKUM
Suffix:
Gender:F
Credentials:RNC, BSN, CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2713 LINDELL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-1916
Mailing Address - Country:US
Mailing Address - Phone:325-223-9257
Mailing Address - Fax:
Practice Address - Street 1:2713 LINDELL AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-1916
Practice Address - Country:US
Practice Address - Phone:325-262-2906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10451374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula