Individual
TARA L MEBIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1325 S CLIFF AVE, SIOUX FALLS, SD 57105-1007
(605) 322-2754
Mailing address
1325 S CLIFF AVE, PO BOX 5045, SIOUX FALLS, SD 57105-1007
(605) 322-2754
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
SD-CRNA CR000723
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255565776
MN BCBS
—
05
—
1255565776
—
MN
05
—
46022474348
—
NE
05
—
5756300
—
SD
01
—
9280534
DAKOTACARE
—
01
—
P00734924
RAILROAD MEDICARE
—
Enumeration date
05/12/2009
Last updated
12/31/2014
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