Provider Demographics
NPI:1871207415
Name:HOWARD, TAMMY
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
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 1:10410 BRIARHURST PL
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-8972
Mailing Address - Country:US
Mailing Address - Phone:704-712-2263
Mailing Address - Fax:
Practice Address - Street 1:10410 BRIARHURST PL
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-8972
Practice Address - Country:US
Practice Address - Phone:704-712-2263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver