Provider Demographics
NPI:1689264210
Name:HALE, TAMMY JEANETTE
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:JEANETTE
Last Name:HALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 MCCOY RD
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:OH
Mailing Address - Zip Code:45656-9607
Mailing Address - Country:US
Mailing Address - Phone:740-978-3462
Mailing Address - Fax:
Practice Address - Street 1:2404 MCCOY RD
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:OH
Practice Address - Zip Code:45656-9607
Practice Address - Country:US
Practice Address - Phone:740-978-3462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant