Individual
MRS. TARA M WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFA
Contact information
Practice address
13430 N MERIDIAN ST, SUITE 275, CARMEL, IN 46032-1405
(317) 582-8810
(317) 582-8863
Mailing address
13430 N MERIDIAN ST, SUITE 275, CARMEL, IN 46032-1405
(317) 582-8810
(317) 582-8863
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
113533
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113533
CFA
IN
Enumeration date
04/01/2009
Last updated
06/22/2011
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