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NPI Code Detail

MEDICARE: TAMMY POLITE

MEDICARE: TAMMY POLITE
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NurseLPN077067GA

General Provider Information

NPI Number : 1477939692
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY POLITE
Provider Business Mailing Address
First Line : 105 SEMINOLE TRL
Second Line :
City : FORT MITCHELL
State : AL
Zip : 36856-6801
Country : US
Telephone Number : 229-291-6617
Fax Number :
Provider Business Practice Location Address
First Line : 105 SEMINOLE TRL
Second Line :
City : FORT MITCHELL
State : AL
Zip : 36856-6801
Country : US
Telephone Number : 229-291-6617
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2015
Last Update Date : 08/11/2015

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Directions to “ TAMMY POLITE ” Practice Location

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