Provider Demographics
NPI:1831075258
Name:DAMRON, TAMMY JEAN
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:JEAN
Last Name:DAMRON
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 497
Mailing Address - Street 2:
Mailing Address - City:DAVIN
Mailing Address - State:WV
Mailing Address - Zip Code:25617-0497
Mailing Address - Country:US
Mailing Address - Phone:681-514-5074
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 497
Practice Address - Street 2:
Practice Address - City:DAVIN
Practice Address - State:WV
Practice Address - Zip Code:25617-0497
Practice Address - Country:US
Practice Address - Phone:681-514-5074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant