Provider Demographics
NPI:1881415586
Name:VILLONO, TAMI LOUISE
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:LOUISE
Last Name:VILLONO
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 1:40955 PLAINVIEW RD
Mailing Address - Street 2:
Mailing Address - City:WOODSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43793-9501
Mailing Address - Country:US
Mailing Address - Phone:740-228-8524
Mailing Address - Fax:
Practice Address - Street 1:40955 PLAINVIEW RD
Practice Address - Street 2:
Practice Address - City:WOODSFIELD
Practice Address - State:OH
Practice Address - Zip Code:43793-9501
Practice Address - Country:US
Practice Address - Phone:740-228-8524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1821206228Medicaid
WV1356607394Medicaid
WV125553494Medicaid