Provider Demographics
NPI:1184753238
Name:WORRELL, TAMMY ADAMS (NP)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:ADAMS
Last Name:WORRELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 S SWING RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-2009
Mailing Address - Country:US
Mailing Address - Phone:336-632-9944
Mailing Address - Fax:
Practice Address - Street 1:335 S SWING RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-2009
Practice Address - Country:US
Practice Address - Phone:336-632-9944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC097918163W00000X
NC940103363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health