NPI | 1588853741 |
---|---|
Former Name | TAMMY LEE ANN BARTHOLOMEW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209019527) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2002016318) |
Enumeration Date | 2007-10-23 |
Last Update Date | 2021-07-14 |