Provider Demographics
NPI:1760127062
Name:TRAMMELL, TABATHA M
Entity Type:Individual
Prefix:MS
First Name:TABATHA
Middle Name:M
Last Name:TRAMMELL
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 1:2010 HEDGE ROW
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-4053
Mailing Address - Country:US
Mailing Address - Phone:678-334-6070
Mailing Address - Fax:
Practice Address - Street 1:2010 HEDGE ROW
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-4053
Practice Address - Country:US
Practice Address - Phone:678-334-6070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-01
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay