Individual
TAMMY ANNE WOLVERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2210 JACKSON ST, ANDERSON, IN 46016-4363
(765) 646-8444
Mailing address
2210 JACKSON ST, ANDERSON, IN 46016-4363
(765) 646-8444
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28105470A
IN
Other
Enumeration date
08/16/2019
Last updated
08/16/2019
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