Provider Demographics
NPI:1255980579
Name:SQUIER, TAMMY LEA
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LEA
Last Name:SQUIER
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 1:52059 230TH ST
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:IA
Mailing Address - Zip Code:51534-6017
Mailing Address - Country:US
Mailing Address - Phone:712-526-2151
Mailing Address - Fax:
Practice Address - Street 1:52059 230TH ST
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:IA
Practice Address - Zip Code:51534-6017
Practice Address - Country:US
Practice Address - Phone:712-526-2151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider