| NPI | 1528134129 |
|---|---|
| Former Name | TAMMY LYNN ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R147980-5) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 3238) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2021-05-10 |