Provider Demographics
NPI:1780269258
Name:WRIGHT, TAMMY (INDEPENDENT PROVIDER)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:INDEPENDENT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 FORESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45216-1513
Mailing Address - Country:US
Mailing Address - Phone:513-362-0773
Mailing Address - Fax:
Practice Address - Street 1:278 FORESTWOOD DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45216-1513
Practice Address - Country:US
Practice Address - Phone:513-805-2351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0340766Medicaid