| NPI | 1184609752 |
|---|---|
| Former Name | TAMMY JOHNSON MELTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 201712) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 90293) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 201712) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2021-03-26 |