MRS. TARA DETTRA, L.M., C.P.M.

Midwife

Active Individual
NPI: 1790929438

Practice Address

1093 A1A BEACH BLVD
PMB 285
Saint Augustine, FL 32080

Phone: (904) 540-7994

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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