Provider Demographics
NPI:1023497914
Name:RHODES KELLY, TAMMIE
Entity type:Individual
Prefix:
First Name:TAMMIE
Middle Name:
Last Name:RHODES KELLY
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 1:231 HOLIDAY CIR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-9126
Mailing Address - Country:US
Mailing Address - Phone:912-777-4924
Mailing Address - Fax:
Practice Address - Street 1:231 HOLIDAY CIR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-9126
Practice Address - Country:US
Practice Address - Phone:912-777-4924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-25
Last Update Date:2015-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker