Individual
TAMARA L POULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6644 E BAYWOOD AVE, MESA, AZ 85206-1747
(480) 321-2000
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN160031
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA1475
AZ
Other
Enumeration date
04/18/2017
Last updated
02/20/2023
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