# TAMERAYEHU TOLLA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1154020998
- **Gender:** Man
- **Credential:** A-GNP-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 2023010980 | MO | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | 53-81975-102 | KS | — |

## Other

- **Enumeration date:** 03/01/2023
- **Last updated:** 08/18/2023