Provider Demographics
NPI:1861063059
Name:HORNING, TAMMY MAY
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:MAY
Last Name:HORNING
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 1:512 GOODRICH ST
Mailing Address - Street 2:
Mailing Address - City:VASSAR
Mailing Address - State:MI
Mailing Address - Zip Code:48768-9205
Mailing Address - Country:US
Mailing Address - Phone:989-823-2391
Mailing Address - Fax:
Practice Address - Street 1:512 GOODRICH ST
Practice Address - Street 2:
Practice Address - City:VASSAR
Practice Address - State:MI
Practice Address - Zip Code:48768-9205
Practice Address - Country:US
Practice Address - Phone:989-823-2391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
183700000X
MI5303022451183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician