Provider Demographics
NPI:1386894020
Name:PEEL, TAMMIE (LPN)
Entity type:Individual
Prefix:
First Name:TAMMIE
Middle Name:
Last Name:PEEL
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 1:6281 MANILA RD
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:OH
Mailing Address - Zip Code:45122-9411
Mailing Address - Country:US
Mailing Address - Phone:513-362-0731
Mailing Address - Fax:
Practice Address - Street 1:6281 MANILA RD
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:OH
Practice Address - Zip Code:45122-9411
Practice Address - Country:US
Practice Address - Phone:513-362-0731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN126253164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse