Provider Demographics
NPI:1356068233
Name:THAI, TAMMY (NP)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:
Last Name:THAI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45085 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-2766
Mailing Address - Country:US
Mailing Address - Phone:571-553-5000
Mailing Address - Fax:
Practice Address - Street 1:45085 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-2766
Practice Address - Country:US
Practice Address - Phone:571-553-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily