Provider Demographics
NPI:1275638348
Name:MCKINLEY, TAMMI LYNN (CPM)
Entity Type:Individual
Prefix:MS
First Name:TAMMI
Middle Name:LYNN
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 E EVANS ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-5210
Mailing Address - Country:US
Mailing Address - Phone:757-524-2640
Mailing Address - Fax:206-333-1379
Practice Address - Street 1:227 E EVANS ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23503-5210
Practice Address - Country:US
Practice Address - Phone:757-524-2640
Practice Address - Fax:206-333-1379
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2021-01-25
Deactivation Date:2008-08-19
Deactivation Code:
Reactivation Date:2008-09-04
Provider Licenses
StateLicense IDTaxonomies
VA0129000017176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife