MEDICARE: TAMMI RENE' NELSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	104100000X	Social Worker
3	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1417726274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMI RENE' NELSON

Provider Business Mailing Address
First Line	:	2814 VIENNA VIEW CT SW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44706-5629
Country	:	US
Telephone Number	:	330-639-8258
Fax Number	:

Provider Business Practice Location Address
First Line	:	2814 VIENNA VIEW CT SW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44706-5629
Country	:	US
Telephone Number	:	333-639-8258
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2023
Last Update Date	:	12/09/2025

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Directions to “ TAMMI RENE' NELSON ” Practice Location

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