Provider Demographics
NPI:1245378140
Name:FRENCH, TAMMY WYNETTE (LPN)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:WYNETTE
Last Name:FRENCH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 NIPGEN ROAD
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:45612-9731
Mailing Address - Country:US
Mailing Address - Phone:740-626-2195
Mailing Address - Fax:740-626-2195
Practice Address - Street 1:191 NIPGEN ROAD
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:45612-9731
Practice Address - Country:US
Practice Address - Phone:740-626-2195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN096520164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2407943Medicaid