Healthcare Provider Details

I. General information

NPI: 1245560762
Provider Name (Legal Business Name): TAMMY R CHILDERS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2010
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

2891 BROWN DEER CT
PICKERINGTON OH
43147-8505
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-6360
  • Fax:
Mailing address:
  • Phone: 614-266-9104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberCOA08957-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: