Provider Demographics
NPI:1740832674
Name:TRULOVE, TAMMY JO (RN, MSN, NCSN)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:JO
Last Name:TRULOVE
Suffix:
Gender:F
Credentials:RN, MSN, NCSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 FOUR MILE RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-4506
Mailing Address - Country:US
Mailing Address - Phone:843-488-6805
Mailing Address - Fax:843-488-7794
Practice Address - Street 1:335 FOUR MILE RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-4506
Practice Address - Country:US
Practice Address - Phone:843-488-6805
Practice Address - Fax:843-488-7794
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC43397163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC43397OtherLLR