Individual
TAMMI BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4040 MEMORIAL PKWY SW, HUNTSVILLE, AL 35802-4364
(256) 533-1970
(256) 705-6477
Mailing address
4040 MEMORIAL PKWY SW, HUNTSVILLE, AL 35802-4364
(256) 533-1970
(256) 705-6477
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4002
AL
164W00000X
Licensed Practical Nurse
2-055887
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330000014
—
AL
Enumeration date
09/14/2015
Last updated
03/27/2019
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