Individual
DEBORAH TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(317) 502-7072
Mailing address
1019 MILLSTONE CT, FRANKLIN, IN 46131-3600
(317) 502-7072
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0017139993
VA
363LF0000X
Family Nurse Practitioner
Primary
71001521A
IN
Other
Enumeration date
08/11/2008
Last updated
07/22/2020
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