NPI | 1790278141 |
---|---|
Other Name | TENNY DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 28504.1837) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 28504) |
Enumeration Date | 2018-06-11 |
Last Update Date | 2020-01-23 |