Provider Demographics
NPI:1225924673
Name:HANEY, TAMMY
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:HANEY
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 1:2908 SAM JONES RD
Mailing Address - Street 2:
Mailing Address - City:PATRICK
Mailing Address - State:SC
Mailing Address - Zip Code:29584-4415
Mailing Address - Country:US
Mailing Address - Phone:843-910-1169
Mailing Address - Fax:
Practice Address - Street 1:2908 SAM JONES RD
Practice Address - Street 2:
Practice Address - City:PATRICK
Practice Address - State:SC
Practice Address - Zip Code:29584-4415
Practice Address - Country:US
Practice Address - Phone:843-910-1169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide