Provider Demographics
NPI:1689856007
Name:WRIGHT, TAMMY RENE (STNA)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:RENE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 AMES ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-4612
Mailing Address - Country:US
Mailing Address - Phone:740-397-2825
Mailing Address - Fax:
Practice Address - Street 1:114 AMES ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-4612
Practice Address - Country:US
Practice Address - Phone:740-397-2825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374325491195376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide