| NPI | 1235383647 |
|---|---|
| Former Name | TABITHA E PARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9306992) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010018) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2026-04-10 |