Tammy Wentworth
Individual provider Active NPI Licensed Practical Nurse · Sherburne, NY
NPI 1144769209 · NPPES record last updated Feb 21, 2017
Key facts
- NPI
- 1144769209
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 313925 (NY)
- Practice address
- 376 County Road 23
Sherburne, NY 13460-4227 - Phone
- (607) 371-1811
- NPI assigned
- Feb 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 313925 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 313925 | NY | Yes |
Addresses
Primary practice location
376 County Road 23
Sherburne, NY 13460-4227
Mailing address
376 County Road 23
Sherburne, NY 13460-4227
Phone (607) 371-1811
Other providers in Sherburne, NY
All providers in Sherburne, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.