| NPI | 1336499904 |
|---|---|
| Former Name | NICOLE RAE TABATT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1207) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 130266-8) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2022-02-11 |