Individual
MRS. TARA LYNN STOKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1215 LAWN AVE, SUITE 100, ELKHART, IN 46514-2450
(574) 293-2893
(574) 293-1298
Mailing address
PO BOX 1887, ELKHART GENERAL PHYSICIAN SERVICES, ELKHART, IN 46515-1887
(574) 389-0542
(574) 522-8505
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28138289A
IN
367A00000X
Advanced Practice Midwife
Primary
72000067A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000622176
ANTHEM
IN
01
—
200353990
MEDICAID
IN
01
—
72000067B
CSR
IN
Enumeration date
07/15/2009
Last updated
12/08/2009
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