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Individual
TAMMY WILBANKS OWENS
Active
Individual
TAMMY WILBANKS OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN146039NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01186539
AMERIGROUP
GA
05
—
418247497D
—
GA
05
—
418247497E
—
GA
01
—
459304
WELLCARE
GA
Enumeration date
03/15/2006
Last updated
02/15/2016
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