Individual
TAMMY LYNN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 BUIST AVE, GREENVILLE, SC 29609-4603
(864) 266-3364
Mailing address
200 BUIST AVE, GREENVILLE, SC 29609-4603
(864) 266-3364
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
80211
SC
363LF0000X
Family Nurse Practitioner
Primary
30002
SC
Other
Enumeration date
10/13/2021
Last updated
02/21/2025
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