Individual
CAITLYN TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
500 WALTER ST NE, SUITE 301, ALBUQUERQUE, NM 87102-2534
(505) 262-7451
Mailing address
5400 GIBSON BLVD SE, 2ND FLOOR / PHARMACY, ALBUQUERQUE, NM 87108-4729
(505) 262-7000
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00007026
NM
Other
Enumeration date
01/06/2010
Last updated
01/06/2010
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