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General NPI Number Information
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NPI Number | 1356161152
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Entity Type | Individual
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Provider Name | TARA MINAEE CNM
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Gender | Female
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 1423 R ST NW APT 301
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City | WASHINGTON
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State | DC
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Zip | 20009-3830
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Country | US
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Telephone | 203-804-6817
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Fax |
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Provider Business Mailing Address
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Address Line | 1423 R ST NW APT 301
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City | WASHINGTON
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State | DC
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Zip | 20009-3830
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Country | US
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Telephone | 203-804-6817
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP1059469
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License Number State | DC
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