Provider Demographics
NPI:1629000500
Name:THOMAS, TAMMY ARLENE (LPN)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:ARLENE
Last Name:THOMAS
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 1:10375 CINCINATII ZANESVILLE RD.
Mailing Address - Street 2:
Mailing Address - City:AMANDA
Mailing Address - State:OH
Mailing Address - Zip Code:43102
Mailing Address - Country:US
Mailing Address - Phone:740-407-4666
Mailing Address - Fax:
Practice Address - Street 1:10375 ST. RT. 22
Practice Address - Street 2:
Practice Address - City:AMANDA
Practice Address - State:OH
Practice Address - Zip Code:43102
Practice Address - Country:US
Practice Address - Phone:740-407-4666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN099606164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse