Provider Demographics
NPI:1831573831
Name:COKER, TAMMY RENAE (CRNP)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:RENAE
Last Name:COKER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:VANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 939
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35011-0939
Mailing Address - Country:US
Mailing Address - Phone:256-329-7100
Mailing Address - Fax:256-329-7617
Practice Address - Street 1:3316 HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-3369
Practice Address - Country:US
Practice Address - Phone:256-329-7100
Practice Address - Fax:256-329-7617
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-087549363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner