Provider Demographics
NPI:1437818499
Name:TARBOX, LIOUDMILA (FNP)
Entity Type:Individual
Prefix:
First Name:LIOUDMILA
Middle Name:
Last Name:TARBOX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LIOUDMILA, LUCY
Other - Middle Name:
Other - Last Name:SAVAGE, SOLOSNIKOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2067 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-8618
Mailing Address - Country:US
Mailing Address - Phone:183-129-5172
Mailing Address - Fax:
Practice Address - Street 1:2930 2ND AVE STE 120
Practice Address - Street 2:
Practice Address - City:MARINA
Practice Address - State:CA
Practice Address - Zip Code:93933-6244
Practice Address - Country:US
Practice Address - Phone:831-622-6935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily