Provider Demographics
NPI:1174134357
Name:ASHMORE, TAMMY LYNN
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:ASHMORE
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 1:114 CLOVER LANE
Mailing Address - Street 2:
Mailing Address - City:BOLT
Mailing Address - State:WV
Mailing Address - Zip Code:25817
Mailing Address - Country:US
Mailing Address - Phone:304-254-8520
Mailing Address - Fax:
Practice Address - Street 1:114 CLOVER LANE
Practice Address - Street 2:
Practice Address - City:BOLT
Practice Address - State:WV
Practice Address - Zip Code:25817
Practice Address - Country:US
Practice Address - Phone:304-254-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator