Provider Demographics
NPI:1134920184
Name:ASHCRAFT, TAMMY CYDELL
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:CYDELL
Last Name:ASHCRAFT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:CYDELL
Other - Last Name:CARRINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-1826
Mailing Address - Country:US
Mailing Address - Phone:615-830-1190
Mailing Address - Fax:
Practice Address - Street 1:100 CHURCH ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1826
Practice Address - Country:US
Practice Address - Phone:615-441-6178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000-506175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist