Provider Demographics
NPI:1770262719
Name:JAMES, TAMI
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:
Last Name:JAMES
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:PO BOX 275
Mailing Address - Street 2:
Mailing Address - City:POCA
Mailing Address - State:WV
Mailing Address - Zip Code:25159-0275
Mailing Address - Country:US
Mailing Address - Phone:304-542-7409
Mailing Address - Fax:
Practice Address - Street 1:4500 1ST AVE
Practice Address - Street 2:LOT C 10
Practice Address - City:NITRO
Practice Address - State:WV
Practice Address - Zip Code:25143
Practice Address - Country:US
Practice Address - Phone:304-542-7409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker