Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
TARA DENDEKKER
Active
Individual
TARA DENDEKKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704301947
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704301947
MI STATE LIC#
MI
01
—
TD301947
BCBSM
MI
Enumeration date
02/03/2014
Last updated
02/03/2014
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