Provider Demographics
NPI:1487395786
Name:BENTON-MYERS, TAMMIE ROCHELLE
Entity type:Individual
Prefix:MS
First Name:TAMMIE
Middle Name:ROCHELLE
Last Name:BENTON-MYERS
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 1:135 DONNA LYN DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:TN
Mailing Address - Zip Code:38060-4608
Mailing Address - Country:US
Mailing Address - Phone:901-314-8420
Mailing Address - Fax:
Practice Address - Street 1:135 DONNA LYN DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:TN
Practice Address - Zip Code:38060-4608
Practice Address - Country:US
Practice Address - Phone:901-314-8420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-02
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health