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NPI Code Detail

MEDICARE: MRS. PAMELA MARY TUTTEN OT, CHT

MEDICARE: MRS. PAMELA MARY TUTTEN OT, CHT
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
1225XH1200XHand Occupational Therapist2278FL
2225XH1200XHand Occupational TherapistOT005043GA
3225X00000XOccupational Therapist13470NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Z0187OTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1558368118
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PAMELA MARY TUTTEN OT, CHT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7217
Fax Number :
Provider Business Practice Location Address
First Line : 1520 SUNDAY DR STE 105
Second Line :
City : RALEIGH
State : NC
Zip : 27607-5254
Country : US
Telephone Number : 919-420-1682
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 10/07/2024

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