Provider Demographics
NPI:1285474791
Name:STILES, TAMMY
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:STILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 N WAGNER AVE
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-1750
Mailing Address - Country:US
Mailing Address - Phone:567-356-0938
Mailing Address - Fax:
Practice Address - Street 1:219 N WAGNER AVE
Practice Address - Street 2:
Practice Address - City:WAPAKONETA
Practice Address - State:OH
Practice Address - Zip Code:45895-1750
Practice Address - Country:US
Practice Address - Phone:567-356-0938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide