Individual
MRS. TARA K CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
100 SCHOOL DR, HUACHUCA CITY SCHOOL, HUACHUCA CITY, AZ 85616
(520) 456-9842
(520) 456-9811
Mailing address
4721 S PUEBLO AVE, SIERRA VISTA, AZ 85650
(520) 803-0868
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN106452
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036384
—
AZ
Enumeration date
09/23/2006
Last updated
07/08/2007
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