Individual
STACY SHANNON TAMMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
125235
NC
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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