| NPI | 1700303518 |
|---|---|
| Other Name | TARA TEDDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009810) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009810) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2024-06-03 |