Healthcare Provider Details

I. General information

NPI: 1578426219
Provider Name (Legal Business Name): TAMMY AMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 TURKEY HILL RD
BELLEFONTE PA
16823-8255
US

IV. Provider business mailing address

129 TURKEY HILL RD
BELLEFONTE PA
16823-8255
US

V. Phone/Fax

Practice location:
  • Phone: 570-263-7155
  • Fax:
Mailing address:
  • Phone: 570-263-7155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number6413013
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: