| NPI | 1184163560 |
|---|---|
| Former Name | CARMEN TANNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 22267) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 175011) |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2023-07-24 |