Individual
MICHELLE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2380 W HORIZON RIDGE PKWY, SUITE 110, HENDERSON, NV 89052-5078
(702) 823-4255
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(435) 256-5177
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7836957-4405
UT
Other
Enumeration date
12/02/2014
Last updated
12/10/2015
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