Individual
JACKIE R TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
638 HARRISON AVE STE 102, PANAMA CITY, FL 32401-2662
(850) 558-4400
Mailing address
638 HARRISON AVE STE 102, PANAMA CITY, FL 32401-2662
(850) 558-4400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9208911
FL
Other
Enumeration date
07/18/2016
Last updated
03/12/2024
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