Provider Demographics
NPI:1821614926
Name:HERMAN, TAMARA STARLING (RDN, LD, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:STARLING
Last Name:HERMAN
Suffix:
Gender:F
Credentials:RDN, LD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 HOSPITAL DR DEPT OF
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-6820
Mailing Address - Country:US
Mailing Address - Phone:706-282-4338
Mailing Address - Fax:706-282-4146
Practice Address - Street 1:163 HOSPITAL DR DEPT OF
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-6820
Practice Address - Country:US
Practice Address - Phone:706-282-4338
Practice Address - Fax:706-282-4146
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD001986133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GALD001986OtherBCBS