Individual
TAMMY DENISE ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA - C
Contact information
Practice address
9175 W OQUENDO RD, LAS VEGAS, NV 89148-1234
(702) 252-7342
Mailing address
6440 SKY POINTE DR, SUITE 140-148, LAS VEGAS, NV 89131-4047
(702) 860-9179
(702) 655-6198
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA742
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2018661
—
NV
05
—
3102661
—
NV
Enumeration date
02/07/2006
Last updated
12/27/2017
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