Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 14798 | TN |
NPI | 1003138587 |
---|---|
Provider Name | Tia Imhoff Mcgee |
First Address | Indianapolis, IN 46204-2624 |
Second Address | Indianapolis, IN 46202-5109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2010 |
Last Update Date | 05/04/2013 |