Provider Demographics
NPI:1871919597
Name:TAMMY SARMIENTO
Entity type:Organization
Organization Name:TAMMY SARMIENTO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SARMIENTO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:317-850-0585
Mailing Address - Street 1:5028 WEST BAY ROAD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168
Mailing Address - Country:US
Mailing Address - Phone:317-850-0585
Mailing Address - Fax:
Practice Address - Street 1:21 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112
Practice Address - Country:US
Practice Address - Phone:888-771-1874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN74004804A261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center