TARRAH DIVINE

SPRINGFIELD, MO
NPI1154745537
Former NameTARRAH BLEVINS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner Family
(Licence: MO  2014003646)
Enumeration Date2014-02-06
Last Update Date2017-08-10
Business Address
TARRAH DIVINE FNP
2115 S FREMONT AVE STE 4300
SPRINGFIELD, MO 65804-2239
Phone number: 417-820-3911
Mailing Address
TARRAH DIVINE FNP
2115 S FREMONT AVE SUITE 4300
SPRINGFIELD, MO 65804
Phone number: 417-820-3911
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