Individual
TANYA ELAN BULLWINKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.
Contact information
Practice address
3225 TIMBER FALL CT, EUREKA, CA 95503-4892
(707) 442-5700
Mailing address
475 HOWARD HEIGHTS RD, EUREKA, CA 95503-9570
(707) 407-7566
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
LM238
CA
Other
Enumeration date
01/14/2009
Last updated
12/19/2012
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