Provider Demographics
NPI:1194505776
Name:TLC FAMILY HEALTH
Entity type:Organization
Organization Name:TLC FAMILY HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CULLUM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:620-741-5430
Mailing Address - Street 1:11663 182ND RD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-7907
Mailing Address - Country:US
Mailing Address - Phone:620-222-1248
Mailing Address - Fax:
Practice Address - Street 1:2508 EDGEMONT DR STE 3
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-3844
Practice Address - Country:US
Practice Address - Phone:620-741-5430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care