| NPI | 1912339292 |
|---|---|
| Former Name | TAMMY JUDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA.18341-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WV APRN42951-FNP-BC) |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2021-01-13 |