Individual
MRS. TAMARA VESTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN153164
Contact information
Practice address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5607
(928) 855-8185
Mailing address
3410 POPPY TRAIL DR, LAKE HAVASU CITY, AZ 86406-7827
(928) 208-3673
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN153164
AZ
Other
Enumeration date
09/28/2012
Last updated
09/28/2012
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