| Doctor Name: | MRS. TAMMY JIBBEN WINGO |
| NPI Number: | 1639172182 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | F.N.P. |
| License Number: | 0024129303 |
| Business Practice Address: | 181 Old Courthouse Rd Appomattox, VA - 245229853 |
| Business Phone Number: | 4343523003 |
| Business Fax Number: | 4343525005 |
| Mailing Address: | 9933 Amelia Springs Rd, JETERSVILLE |
| State: | VA |
| Postal Code: | 230832405 |
| Phone Number: | 8045616319 |
| Fax Number: | |
| NPI Enumeration Date: | 05/28/2005 |
| NPI Last Update Date: | 05/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 0024129303 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |