Healthcare Provider Details

I. General information

NPI: 1962731455
Provider Name (Legal Business Name): TAMMY DAWN LAMB R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS TAMMY DAWN RUTHERFORD

II. Dates (important events)

Enumeration Date: 12/14/2009
Last Update Date: 12/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65608 SAM RUSSELL RD
HAMDEN OH
45634-8833
US

IV. Provider business mailing address

65608 SAM RUSSELL RD
HAMDEN OH
45634-8833
US

V. Phone/Fax

Practice location:
  • Phone: 740-596-1010
  • Fax:
Mailing address:
  • Phone: 740-596-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number332522
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: