Individual
TOMMIE L WANNAMAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1107 E WILLAMETTE AVE, COLORADO SPRINGS, CO 80903-2810
(719) 510-1702
Mailing address
1107 E WILLAMETTE AVE, COLORADO SPRINGS, CO 80903-2810
(719) 510-1702
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0084488
CO
Other
Enumeration date
01/20/2025
Last updated
01/20/2025
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