NPI | 1811134802 |
---|---|
Former Name | TARA REED |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010120) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP010120) |
363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP010120) | |
Enumeration Date | 2009-01-13 |
Last Update Date | 2020-12-19 |