Provider Demographics
NPI:1720335631
Name:ROTON, TAMMY MARIE (NP-C)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:MARIE
Last Name:ROTON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 SYCAMORE ST
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:COTTONPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71327-3403
Mailing Address - Country:US
Mailing Address - Phone:469-282-2711
Mailing Address - Fax:469-282-2609
Practice Address - Street 1:1135 EXPRESSWAY DR STE 200A
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-6653
Practice Address - Country:US
Practice Address - Phone:318-561-0001
Practice Address - Fax:318-561-0121
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06855363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily