Individual
TARA FROST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
231 S JEFFERSON ST, WATERFORD, WI 53185-4127
(262) 492-9211
Mailing address
231 S JEFFERSON ST, WATERFORD, WI 53185-4127
(262) 492-9211
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
136113
WI
Other
Enumeration date
02/15/2017
Last updated
02/15/2017
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