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Individual
TANNER DAVID FREE
Active
Individual
TANNER DAVID FREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN11023881
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001618680
ANTHEM
IN
01
—
000001618766
ANTHEM
IN
01
—
000001619023
ANTHEM
IN
05
—
300057259
—
IN
Enumeration date
09/13/2021
Last updated
09/09/2024
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