Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN-64878FNP-BC | WV |
NPI | 1003325150 |
---|---|
Provider Name | Tamara Rena Postlethwait |
First Address | Parkersburg, WV 26101-2504 |
Second Address | Parkersburg, WV 26101-3247 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2017 |
Last Update Date | 25/07/2018 |