Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 0024128995 | VA |
NPI | 1477951515 |
---|---|
Provider Name | Dr. Tauna Gulley |
First Address | Wise, VA 24293 |
Second Address | Clintwood, VA 24228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2014 |
Last Update Date | 05/12/2014 |