| NPI | 1023779311 |
|---|---|
| Former Name | TAMMY JANE TAMMY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL F02210970) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-108051) |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2024-04-10 |