NPI | 1811943426 |
---|---|
Former Name | TAMMY CARROLL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 132396) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 75347) |
364S00000X Clinical Nurse Specialist (Licence: KS 74694) | |
Enumeration Date | 2006-05-25 |
Last Update Date | 2024-07-10 |