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Individual
MS. TARA KATHLEEN MCMORRIS
Active
Individual
MS. TARA KATHLEEN MCMORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006082
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417961137
BCBSM - BRONSON
MI
05
—
1942589874
—
MI
Enumeration date
08/09/2011
Last updated
09/21/2016
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