Provider Demographics
NPI:1033922067
Name:GOLDY, TAMMY LYNN I (PSS)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:GOLDY
Suffix:I
Gender:F
Credentials:PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 MARTIN CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40337-9110
Mailing Address - Country:US
Mailing Address - Phone:859-953-1006
Mailing Address - Fax:
Practice Address - Street 1:1015 W LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1241
Practice Address - Country:US
Practice Address - Phone:859-644-5171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist