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Individual

MRS. TARA L DI BUONO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
180 W ESPLANADE AVE, KENNER, LA 70065-2467
(504) 468-8600
Mailing address
1111 MEDICAL CENTER BLVD, STE 450, MARRERO, LA 70072-3155
(504) 834-2062
(504) 831-7429

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
05522
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05035526
MS
05
1306525
LA
Enumeration date
07/18/2008
Last updated
09/13/2018
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