Provider Demographics
NPI:1750433207
Name:KINCAID, TAMMY JAMES (CRNA)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:JAMES
Last Name:KINCAID
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 GATOR DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-9357
Mailing Address - Country:US
Mailing Address - Phone:919-221-1527
Mailing Address - Fax:
Practice Address - Street 1:2700 WAYNE MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534
Practice Address - Country:US
Practice Address - Phone:919-731-6068
Practice Address - Fax:919-731-6025
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC140107163W00000X
NC076104367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse