| NPI | 1801208418 |
|---|---|
| Former Name | KIM NICOLE TANTLINGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VT 101.0107576) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2284328) |
| Enumeration Date | 2014-05-30 |
| Last Update Date | 2016-12-12 |