Provider Demographics
NPI:1851534416
Name:JOHNSON, TAMMEY E (CM II)
Entity Type:Individual
Prefix:
First Name:TAMMEY
Middle Name:E
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CM II
Other - Prefix:
Other - First Name:TAMMEY
Other - Middle Name:E
Other - Last Name:ALLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2810 BERMUDA AVE
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-5023
Mailing Address - Country:US
Mailing Address - Phone:918-960-4469
Mailing Address - Fax:
Practice Address - Street 1:12005 E 470 RD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-3737
Practice Address - Country:US
Practice Address - Phone:918-342-0770
Practice Address - Fax:918-342-0087
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator