Individual
TARA LYNN WEIRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
12990 MANCHESTER RD, DES PERES, MO 63131-1860
(314) 367-1181
Mailing address
16552 STATE HIGHWAY 109, DOW, IL 62022-3067
(618) 567-3706
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209006957
IL
Other
Enumeration date
01/31/2008
Last updated
04/21/2021
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