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Individual
TARIS GONZALEZ
Active
Individual
TARIS GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001601A
IN
363LA2100X
Acute Care Nurse Practitioner
71001601
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200460280
—
IN
01
—
P01170026
RR MEDICARE PTAN
IN
Enumeration date
06/04/2007
Last updated
07/23/2026
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