| NPI | 1760784631 |
|---|---|
| Former Name | CAROLYN JEAN TANKERSLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP119530) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 596794) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2014-09-17 |