Individual
TAMMY SHOPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 293-8300
Mailing address
233 WATERVLIET AVE, DAYTON, OH 45420-2454
(937) 304-4634
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN.413380
OH
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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