| NPI | 1346248192 |
|---|---|
| Former Name | TAMMY BARRETT WIDICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: WA AP 60118439) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 2192222) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 200960025CRNA) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: FL ARNP2192222) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2010-09-13 |