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Individual

TAMI TERESE DITTBURNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ANP-BC

Contact information

Practice address
617 E LOOP 499, SUITE C, HARLINGEN, TX 78550-2477
(956) 428-8264
(956) 425-3642
Mailing address
617 E LOOP 499, SUITE C, HARLINGEN, TX 78550-2477
(956) 428-8264
(956) 425-3642

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
520212
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
TXB165562
PTAN
Enumeration date
09/07/2006
Last updated
12/21/2012
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