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NPI Code Detail

MEDICARE: TAMMY ANGLIN LPN

MEDICARE: TAMMY ANGLIN LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse21400WV

General Provider Information

NPI Number : 1134051980
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY ANGLIN LPN
Provider Business Mailing Address
First Line : 400 TRACY WAY
Second Line :
City : CHARLESTON
State : WV
Zip : 25311-1280
Country : US
Telephone Number : 304-720-0262
Fax Number : 304-720-0262
Provider Business Practice Location Address
First Line : 400 TRACY WAY
Second Line :
City : CHARLESTON
State : WV
Zip : 25311-1280
Country : US
Telephone Number : 304-720-0262
Fax Number : 304-720-0262
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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