| NPI | 1134505647 |
|---|---|
| Former Name | TAMMY WYNETTE BAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: SC 19641) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: SC 19641) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2016-07-27 |