Individual
BERNARD P TADDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
(563) 336-3125
Mailing address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
(563) 336-3125
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209002893
IL
363LF0000X
Family Nurse Practitioner
Primary
A080476
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02253
IA BCBS SEEN IN DAVENPORT
IA
01
—
079606
HEALTH ALLIANCE
—
01
—
421060724
BILLING TAX ID# FOR CHC
IA
01
—
42106072433
JOHN DEERE HEALTH
IA
01
—
5201162
CONTROLLED SUBSTANCE#
IA
01
—
IA0133
JOHN DEERE EDI#
IA
01
—
S55307
UPIN
—
Enumeration date
09/21/2005
Last updated
03/07/2023
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