Individual
KATY C TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 202-2000
Mailing address
2003 CORBETT RD, ORLANDO, FL 32826-4905
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9413171
FL
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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