Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 19270 | TN |
NPI | 1013308642 |
---|---|
Provider Name | Tammy Warren |
First Address | Murfreesboro, TN 37129-1208 |
Second Address | Murfreesboro, TN 37129-1392 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2015 |
Last Update Date | 17/09/2021 |