Provider Demographics
NPI:1699220921
Name:TATE, TAMMY (ADMINISTRATOR)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:TATE
Suffix:
Gender:F
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 RICHLAND ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-4625
Mailing Address - Country:US
Mailing Address - Phone:828-216-8376
Mailing Address - Fax:828-484-9092
Practice Address - Street 1:119 RICHLAND ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-4625
Practice Address - Country:US
Practice Address - Phone:828-216-8376
Practice Address - Fax:828-484-9092
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home