Provider Demographics
NPI:1952361743
Name:HOWARD, TAMMY SUE
Entity Type:Individual
Prefix:MISS
First Name:TAMMY
Middle Name:SUE
Last Name:HOWARD
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 28231
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-0231
Mailing Address - Country:US
Mailing Address - Phone:614-604-5613
Mailing Address - Fax:614-878-7866
Practice Address - Street 1:445 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-2224
Practice Address - Country:US
Practice Address - Phone:614-604-5613
Practice Address - Fax:614-878-7866
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2421472Medicaid