| NPI | 1518202753 | 
|---|---|
| Former Name | TARRIE ANN DAVIS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704144431)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704144431)  | 
| Enumeration Date | 2012-11-28 | 
| Last Update Date | 2025-03-02 |