Provider Demographics
NPI:1639135924
Name:GAINEY, TAMMIE (FNP, PMHNP)
Entity Type:Individual
Prefix:
First Name:TAMMIE
Middle Name:
Last Name:GAINEY
Suffix:
Gender:F
Credentials:FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1825
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28380-1825
Mailing Address - Country:US
Mailing Address - Phone:910-562-9882
Mailing Address - Fax:910-562-9955
Practice Address - Street 1:523 ROCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379
Practice Address - Country:US
Practice Address - Phone:910-562-9882
Practice Address - Fax:910-562-9955
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5003992363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010178762Medicaid