Provider Demographics
NPI:1962731455
Name:LAMB, TAMMY DAWN (RN)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:DAWN
Last Name:LAMB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:TAMMY
Other - Middle Name:DAWN
Other - Last Name:RUTHERFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65608 SAM RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:OH
Mailing Address - Zip Code:45634-8833
Mailing Address - Country:US
Mailing Address - Phone:740-596-1010
Mailing Address - Fax:
Practice Address - Street 1:65608 SAM RUSSELL RD
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:OH
Practice Address - Zip Code:45634-8833
Practice Address - Country:US
Practice Address - Phone:740-596-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332522163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse