Provider Demographics
NPI:1629310529
Name:JONES, TAMMY LIPSCOMB (RN)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:LIPSCOMB
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 HARDEN STREET EXT
Mailing Address - Street 2:SUITE 203
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6894
Mailing Address - Country:US
Mailing Address - Phone:803-434-4423
Mailing Address - Fax:803-434-3773
Practice Address - Street 1:3555 HARDEN STREET EXT
Practice Address - Street 2:SUITE 203
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6894
Practice Address - Country:US
Practice Address - Phone:803-434-4423
Practice Address - Fax:803-434-3773
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC48503163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health