Healthcare Provider Details

I. General information

NPI: 1407104946
Provider Name (Legal Business Name): TAMMY B BILLINGS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 02/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4049 MT CARMEL RD
COVINGTON TN
38019-7237
US

IV. Provider business mailing address

4049 MT CARMEL RD
COVINGTON TN
38019-7237
US

V. Phone/Fax

Practice location:
  • Phone: 901-359-6744
  • Fax:
Mailing address:
  • Phone: 901-359-6744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16885
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number16885
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: