Provider Demographics
NPI:1306111646
Name:WOODS, TAMARA ANN GALLIMORE (LMBT, MBA)
Entity type:Individual
Prefix:MRS
First Name:TAMARA ANN
Middle Name:GALLIMORE
Last Name:WOODS
Suffix:
Gender:F
Credentials:LMBT, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 KNIGHT RD
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-9187
Mailing Address - Country:US
Mailing Address - Phone:336-992-6135
Mailing Address - Fax:
Practice Address - Street 1:2170 KNIGHT RD
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-9187
Practice Address - Country:US
Practice Address - Phone:336-992-6135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC874374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula