Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP5670 | AZ |
NPI | 1003229782 |
---|---|
Provider Name | Mrs. Tamera Ann Querrey |
First Address | Phoenix, AZ 85032-2105 |
Second Address | Phoenix, AZ 85032-2105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2014 |
Last Update Date | 02/07/2014 |