Individual
TAMMIA ANTOINETTE GATLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1922 GRASSY BANKS DR, RALEIGH, NC 27610-6472
(984) 201-4167
Mailing address
1922 GRASSY BANKS DR, RALEIGH, NC 27610-6472
(984) 201-4167
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
88339
NC
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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