Provider Demographics
NPI:1144245739
Name:HIGHTOWER, TAMMY A (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:A
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BAMBERG
Mailing Address - State:SC
Mailing Address - Zip Code:29003-2801
Mailing Address - Country:US
Mailing Address - Phone:803-245-8154
Mailing Address - Fax:
Practice Address - Street 1:620 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-6980
Practice Address - Country:US
Practice Address - Phone:803-536-1571
Practice Address - Fax:803-536-1463
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2013-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC890363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC413093Medicaid
SC413093Medicaid
P08798Medicare UPIN