Provider Demographics
NPI:1174874283
Name:CARTER, TAMMIE LYNNETTE (CSFA)
Entity type:Individual
Prefix:
First Name:TAMMIE
Middle Name:LYNNETTE
Last Name:CARTER
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 STONECREST BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6810
Mailing Address - Country:US
Mailing Address - Phone:615-223-9935
Mailing Address - Fax:615-768-7871
Practice Address - Street 1:200 STONECREST BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6810
Practice Address - Country:US
Practice Address - Phone:615-223-9935
Practice Address - Fax:615-768-7871
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN116601246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant