Provider Demographics
NPI:1457953176
Name:MARSH, TAMMY LYNN
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:MARSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:LYNN
Other - Last Name:BICKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2795 KASSON RD
Mailing Address - Street 2:
Mailing Address - City:MOATSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26405-8289
Mailing Address - Country:US
Mailing Address - Phone:304-694-0296
Mailing Address - Fax:
Practice Address - Street 1:2795 KASSON RD
Practice Address - Street 2:
Practice Address - City:MOATSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26405-8289
Practice Address - Country:US
Practice Address - Phone:304-694-0296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant