Individual
MRS. TARA BLAKE COMARDELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA, MNNA, BSN
Contact information
Practice address
12293 OLD MILLSTONE DR., GEISMAR, LA 70734
(407) 748-3405
Mailing address
12293 OLD MILLSTONE DR, GEISMAR, LA 70734-3237
(407) 748-1602
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
TAP002845
LA
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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