Most Relevant Information
Provider Data
| NPI Number: | 1003414707 |
| Provider Name: | TAMMY JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 376K00000X |
| Specialty: | Nurse's Aide |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/14/2020 |
| Last Updated: | 10/14/2020 |
Provider Practice Location
1307 WILLIAMSTOWN PIKE
OPTIONAL
WILLIAMSTOWN
WV
26187
Practice Location Phone/Fax
| Phone: | 3044552757 |
| Fax: |
Provider Mailing Location
1307 WILLIAMSTOWN PIKE
OPTIONAL
WILLIAMSTOWN
WV
26187
Provider Mailing Phone/Fax
| Phone: | 3044552757 |
| Fax: |