Provider Demographics
NPI:1659839850
Name:STILES, TAMMY LEE (LPN)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LEE
Last Name:STILES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14066 AMERO LN
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-6207
Mailing Address - Country:US
Mailing Address - Phone:352-398-2246
Mailing Address - Fax:
Practice Address - Street 1:14066 AMERO LN
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-6207
Practice Address - Country:US
Practice Address - Phone:352-398-2246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5189335164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5189335OtherLICENSED PRACTICAL NURSE