Provider Demographics
NPI:1992128656
Name:WINGO-SALMOND, TAMMY
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:
Last Name:WINGO-SALMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276B JAMES ASBURY DR NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-2984
Mailing Address - Country:US
Mailing Address - Phone:423-464-5776
Mailing Address - Fax:423-464-5665
Practice Address - Street 1:1970 JORDAN AVE NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-1900
Practice Address - Country:US
Practice Address - Phone:423-790-7662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-30
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000018281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily