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General NPI Number Information
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NPI Number | 1194907543
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Entity Type | Individual
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Provider Name | TARA MUNROE CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 925 HIGHLAND BLVD STE 1180
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City | BOZEMAN
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State | MT
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Zip | 59715-6905
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Country | US
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Telephone | 406-582-4963
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Fax | 706-396-3252
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Provider Business Mailing Address
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Address Line | 400 10TH ST E
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City | WACONIA
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State | MN
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Zip | 55387-4552
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Country | US
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Telephone | 888-209-0305
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Fax | 952-442-3620
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 087174
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN-100960
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License Number State | MT
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