Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | AG09170056 | VA |
Y | 363LG0600X | Nurse Practitioner - Gerontology | 0024175892 | VA |
N | 363LG0600X | Nurse Practitioner - Gerontology | AG09170056 | VA |
NPI | 1013428341 |
---|---|
Provider Name | Tami Salomon |
First Address | Chesapeake, VA 23321-5205 |
Second Address | Chesapeake, VA 23321-5205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2017 |
Last Update Date | 29/05/2019 |