| NPI | 1699139931 |
|---|---|
| Former Name | TAMMY CAUDILL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH 19148) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3010158) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2019-06-25 |