Individual
TAMMY LISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1514 MERIDIAN WAY, VIRGINIA BEACH, VA 23454-5112
(757) 752-4446
Mailing address
1514 MERIDIAN WAY, VIRGINIA BEACH, VA 23454-5112
(757) 752-4446
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001198593
VA
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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