Individual
TARA MARIE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
736 SW WASHINGTON ST STE 2A, PEORIA, IL 61602-1643
(309) 497-0300
Mailing address
736 SW WASHINGTON ST STE 2A, PEORIA, IL 61602-1643
(309) 497-0300
Taxonomy
Speciality
Code
Description
License number
State
163WX0800X
Orthopedic Registered Nurse
041416169
IL
363LX0106X
Occupational Health Nurse Practitioner
Primary
209.027825
IL
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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