Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 0024167218 | VA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 0024167218 | VA |
NPI | 1205990983 |
---|---|
Provider Name | Tabitha T Garrison |
First Address | Broadway, VA 22815 |
Second Address | Broadway, VA 22815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 29/01/2021 |