Individual
TARA L POPKES
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
PO BOX 5045, ATTN: C.B.O. PROV ENROLLMT, SIOUX FALLS, SD 57117-5045
(605) 322-6428
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000760
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316237084
BCBS MN
—
05
—
1316237084
—
IA
05
—
1316237084
—
MN
05
—
46022474348
—
NE
05
—
5757490
—
SD
01
—
9304223
DAKOTACARE
—
Enumeration date
04/14/2011
Last updated
05/15/2014
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