MEDICARE: TAMMY SUE BOYETTE

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
1	1041C0700X	Clinical Social Worker	10028	TN

General Provider Information

NPI Number	:	1992635668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY SUE BOYETTE

Provider Business Mailing Address
First Line	:	1815 HIGHWAY 130 E
Second Line	:
City	:	SHELBYVILLE
State	:	TN
Zip	:	37160-7404
Country	:	US
Telephone Number	:	931-571-0244
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 HIGHWAY 130 E
Second Line	:
City	:	SHELBYVILLE
State	:	TN
Zip	:	37160-7404
Country	:	US
Telephone Number	:	931-571-0244
Fax Number	:

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

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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Directions to “ TAMMY SUE BOYETTE ” Practice Location

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