Provider Demographics
NPI:1396344123
Name:BOWERS, TAMMY RENEE
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:RENEE
Last Name:BOWERS
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 1:1151 MONTEREY DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-2443
Mailing Address - Country:US
Mailing Address - Phone:740-398-7904
Mailing Address - Fax:
Practice Address - Street 1:1151 MONTEREY DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-2443
Practice Address - Country:US
Practice Address - Phone:740-398-7904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No347C00000XTransportation ServicesPrivate Vehicle