Provider Demographics
NPI:1063784114
Name:ROMAN, TAMMY LYNNE (LPN)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:LYNNE
Last Name:ROMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 0AKWOOD DR.
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44054
Mailing Address - Country:US
Mailing Address - Phone:440-937-8478
Mailing Address - Fax:
Practice Address - Street 1:5330 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44054-2405
Practice Address - Country:US
Practice Address - Phone:440-937-8478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN131767164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse