NPI | 1265847131 |
---|---|
Former Name | TAMMY J. BRANNON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 2013017052) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 5994-33) |
Enumeration Date | 2014-06-30 |
Last Update Date | 2024-06-14 |