Provider Demographics
NPI:1942831797
Name:OCHOA, TAMMY
Entity Type:Individual
Prefix:MISS
First Name:TAMMY
Middle Name:
Last Name:OCHOA
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 1:400 N PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:MANGUM
Mailing Address - State:OK
Mailing Address - Zip Code:73554-3034
Mailing Address - Country:US
Mailing Address - Phone:580-782-3371
Mailing Address - Fax:580-782-2313
Practice Address - Street 1:400 N PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:MANGUM
Practice Address - State:OK
Practice Address - Zip Code:73554-3034
Practice Address - Country:US
Practice Address - Phone:580-782-3371
Practice Address - Fax:580-782-2313
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant