| NPI | 1679790406 |
|---|---|
| Former Name | TAMMY LEE MATTHEWS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 344432) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 400794) |
| 363L00000X Nurse Practitioner (Licence: NY 344432) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2021-05-18 |