Healthcare Provider Details

I. General information

NPI: 1235056706
Provider Name (Legal Business Name): TAMMY SUE SEAMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMMY SUE WALKER

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 RONALD RD
COUNCIL BLUFFS IA
51501-8129
US

IV. Provider business mailing address

3501 RONALD RD
COUNCIL BLUFFS IA
51501-8129
US

V. Phone/Fax

Practice location:
  • Phone: 712-406-9024
  • Fax:
Mailing address:
  • Phone: 712-406-9024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number514YY7706
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: