Mundy, Tammy Lea

Mundy, Tammy Lea is an individual health care provider with primary practice located at 777 S Main St , Clinton IN 47842-2493. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mundy, Tammy Lea can be contacted via phone (765) 828-1003.

Contact Information

Primary practice address
777 S Main St Clinton IN 47842-2493
Phone: (765) 828-1003
Fax: (765) 828-1030
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71000966A Indiana

Profile Details

NPI number 1447473533
LBN Legal business name Mundy, Tammy Lea
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2007
Last updated May 16th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447473533 NPPES
Indiana MEDICAID 200846710
Indiana Other P00416616

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