Provider Demographics
NPI:1487091880
Name:FURR, TAMMY WATTS (RN)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:WATTS
Last Name:FURR
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 1:1000 DAVE GIBSON BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-6416
Mailing Address - Country:US
Mailing Address - Phone:803-548-8246
Mailing Address - Fax:803-548-8373
Practice Address - Street 1:2233 DEERFIELD DR
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-6941
Practice Address - Country:US
Practice Address - Phone:803-548-2527
Practice Address - Fax:803-547-4696
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC31826163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse