| NPI | 1780348326 |
|---|---|
| Former Name | ANNIE NICHOLE TAMAYO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2021016502) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MO 2007029225) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 5380216091) | |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2023-02-27 |