Individual
ALLIS VANESSA TAVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
167 NORTH MAIN STREET, TUBA CITY, AZ 86045-0600
(928) 283-2781
(928) 283-2677
Mailing address
PO BOX 600, PFS BUSINESS OFFICE, TUBA CITY, AZ 86045-0600
(928) 283-2094
(928) 283-2677
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/21/2013
Last updated
11/21/2013
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