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TASHERA EVERLOIS NARCISSA PERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2920 S MCINTIRE DR, SUITE 250, BLOOMINGTON, IN 47403-4221
(812) 322-9217
(812) 330-4474
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01074999A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201291850
IN
Enumeration date
03/21/2011
Last updated
12/21/2020
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