Provider Demographics
NPI:1205538972
Name:OAKES, TAMMY SUE (CCHW)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:SUE
Last Name:OAKES
Suffix:
Gender:F
Credentials:CCHW
Other - Prefix:MRS
Other - First Name:TAMMY
Other - Middle Name:MOORE
Other - Last Name:OAKES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CCHW
Mailing Address - Street 1:51 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BLACKSTONE
Mailing Address - State:VA
Mailing Address - Zip Code:23824-9202
Mailing Address - Country:US
Mailing Address - Phone:434-321-3569
Mailing Address - Fax:
Practice Address - Street 1:295 W CAMPUS DR
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24061-2734
Practice Address - Country:US
Practice Address - Phone:786-553-6234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 174H00000X
VA3474172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator