# TARA S KAUFFMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1053510651
- **Gender:** F
- **Credential:** ARNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 3005457 | KY | Yes |
| 363L00000X | Nurse Practitioner | 44683 | KY | — |

## Other

- **Enumeration date:** 07/13/2007
- **Last updated:** 12/07/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000525603 | ANTHEM PIN | KY |
| 01 | — | 000000693050 | ANTHEM - NCVA | KY |
| 01 | — | 000057080U | HUMANA - NCVA | KY |
| 01 | — | 122021 | SIHO - NCVA | KY |
| 05 | — | 7100146890 | — | KY |
| 01 | — | P00992184 | RR MEDICARE KY | KY |