Provider Demographics
NPI:1932864006
Name:SCROGGINS, TAMRA
Entity Type:Individual
Prefix:MS
First Name:TAMRA
Middle Name:
Last Name:SCROGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TAMRA
Other - Middle Name:
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2808 MONTA PL
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-6036
Mailing Address - Country:US
Mailing Address - Phone:918-814-6456
Mailing Address - Fax:
Practice Address - Street 1:2808 MONTA PL
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-6036
Practice Address - Country:US
Practice Address - Phone:918-814-6456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator