Tamarra Lynn Subyantoro, APN

NPI #1942842018 in Peoria, Illinois

Provider Information

NPI Number
1942842018
Entity Type
Individual
Name
Tamarra Lynn Subyantoro, APN
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Nurse Practitioner - Family
Credential
APN
Enumeration Date
Oct 10, 2019
Last Updated
Sep 27, 2024

Practice Location

Address
5114 N GLEN PARK PLACE RD STE 110
City
Peoria
ZIP Code
61614-4686
Phone
(309) 683-5600

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner - FamilyFamily
Nurse Practitioner

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