Individual
TARA ANN HALLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1024 S LEMAY AVE, FORT COLLINS, CO 80524-3929
(303) 306-7783
(303) 306-7753
Mailing address
PO BOX 912215, DENVER, CO 80291-2215
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
44750
CO
207P00000X
Emergency Medicine Physician
5101014849
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125166000
—
WY
05
—
80550070
—
CO
01
—
P00371081
RAILROAD MEDICARE
—
01
—
S5008
BCBS
—
Enumeration date
11/23/2005
Last updated
05/13/2014
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