Provider Demographics
NPI:1649070913
Name:LOWDERMILK, TAMMY RENEE
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:RENEE
Last Name:LOWDERMILK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BEULAH DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537-8540
Mailing Address - Country:US
Mailing Address - Phone:304-517-4294
Mailing Address - Fax:
Practice Address - Street 1:102 BEULAH DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:WV
Practice Address - Zip Code:26537-8540
Practice Address - Country:US
Practice Address - Phone:304-517-4294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant