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Individual
MRS. TARA M. HOLDER
Active
Individual
MRS. TARA M. HOLDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, ENP, FNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
660917
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1658650-01
—
TX
01
—
7702695
AETNA
TX
01
—
8N6091
BLUE CROSS BLUE SHIELD
TX
01
—
P00141387
RAILROAD MEDICARE
TX
Enumeration date
01/17/2007
Last updated
11/23/2015
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