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General NPI Number Information
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NPI Number | 1710702766
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Entity Type | Individual
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Provider Name | DAKOTA MARIE TARANGO
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Gender | Female
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Dates
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Enumeration Date | 11/15/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 410 BENEDICTA AVE
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City | TRINIDAD
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State | CO
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Zip | 81082-2005
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Country | US
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Telephone | 719-845-4262
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Fax |
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Provider Business Mailing Address
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Address Line | 529 W TOPEKA AVE
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City | TRINIDAD
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State | CO
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Zip | 81082-1439
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Country | US
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Telephone |
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN.1688823
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License Number State | CO
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