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NPI Code Detail

MEDICARE: TARA DUPUY HERRERO CRNA

MEDICARE: TARA DUPUY HERRERO CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist2925652FL
2367500000XCertified Registered Nurse Anesthetist293397AZ

General Provider Information

NPI Number : 1376565291
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA DUPUY HERRERO CRNA
Provider Business Mailing Address
First Line : 322 PLEASANT HILL RD
Second Line :
City : LANDRUM
State : SC
Zip : 29356-8727
Country : US
Telephone Number : 864-468-5429
Fax Number :
Provider Business Practice Location Address
First Line : 1840 N JASPER DR STE 1
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-1634
Country : US
Telephone Number : 928-558-7001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 06/22/2023

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Directions to “ TARA DUPUY HERRERO CRNA” Practice Location

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