Healthcare Provider Details

I. General information

NPI: 1427456987
Provider Name (Legal Business Name): TAMMY POTEET RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 12/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 UNION SCHOOL RD
GALLATIN TN
37066-2084
US

IV. Provider business mailing address

320 LISA LN
GALLATIN TN
37066-5524
US

V. Phone/Fax

Practice location:
  • Phone: 615-206-1100
  • Fax: 615-206-9748
Mailing address:
  • Phone: 615-516-7810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN0000100484
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: