Individual
TAMMY LYNN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 OPERA HOUSE RD, MADRID, NM 87010-9760
(505) 225-4092
Mailing address
PO BOX 845, CERRILLOS, NM 87010-0845
(505) 225-4092
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
04/03/2018
Last updated
04/03/2018
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