Healthcare Provider Details

I. General information

NPI: 1639534191
Provider Name (Legal Business Name): TARA L ALAUF CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARA L GUILER

II. Dates (important events)

Enumeration Date: 12/28/2015
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 W LINCOLN AVE
WEST ALLIS WI
53227-2409
US

IV. Provider business mailing address

8901 W LINCOLN AVE
WEST ALLIS WI
53227-2409
US

V. Phone/Fax

Practice location:
  • Phone: 414-283-6000
  • Fax: 414-649-1328
Mailing address:
  • Phone: 414-283-6000
  • Fax: 414-649-1328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number6779-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: