Individual
MRS. TAMMY J. SOMERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-8983
(704) 355-8994
Mailing address
4400 GOLF ACRES DR, SUITE A, CHARLOTTE, NC 28208-5968
(704) 512-6428
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
124619
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052016
—
NC
05
—
NAN719
—
SC
Enumeration date
08/03/2006
Last updated
05/12/2017
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