Individual
MRS. TARA S PRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1318 HARRISON AVE, MCCOMB, MS 39648-2830
(601) 684-2300
(601) 684-2360
Mailing address
PO BOX 1268, MCCOMB, MS 39649-1268
(601) 684-2300
(601) 684-2360
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
R863839
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04178340
—
MS
Enumeration date
07/19/2006
Last updated
12/11/2014
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