MRS. TARA DETTRA, L.M., C.P.M.
Midwife
Active
Individual
NPI: 1790929438
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Midwife | 176B00000X | Yes | MW 227 (FL) |
Frequently Asked Questions
NPI 1790929438 is the National Provider Identifier for MRS. TARA DETTRA, L.M., C.P.M., a Midwife provider located in Saint Augustine, FL. This NPI was enumerated on April 24, 2009.
MRS. TARA DETTRA, L.M., C.P.M. practices at 1093 A1A BEACH BLVD, PMB 285, Saint Augustine, FL 32080.
Quick Facts
- NPI
- 1790929438
- Type
- Individual
- Enumerated
- Apr 24, 2009
- Last Updated
- Apr 24, 2009
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