Individual
ROBERTA TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-RX, FNP-C
Contact information
Practice address
450 KILAUEA AVE, STE. 105 BAY CLINIC, INC., HILO, HI 96720-3089
(808) 961-4071
(808) 961-5678
Mailing address
HC 2 BOX 9608, KEAAU, HI 96749-9332
(808) 542-2742
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-22282
HI
363LF0000X
Family Nurse Practitioner
Primary
1427
HI
Other
Enumeration date
07/30/2008
Last updated
02/07/2017
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