Provider Demographics
NPI:1417547985
Name:DROLLETTE, TAMMY M (RN)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:M
Last Name:DROLLETTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CLOVER DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-3502
Mailing Address - Country:US
Mailing Address - Phone:585-362-1155
Mailing Address - Fax:
Practice Address - Street 1:14 CLOVER DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-3502
Practice Address - Country:US
Practice Address - Phone:585-362-1155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY395317-01163WD1100X, 163WG0600X, 163WH1000X, 163WM0705X, 163WR0400X, 163WW0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WW0000XNursing Service ProvidersRegistered NurseWound Care