Individual
MS. TARA LEE BIBEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
415 W MULBERRY ST, DULUTH, MN 55811
(218) 259-2716
Mailing address
415 W MULBERRY ST, DULUTH, MN 55811
(218) 259-2716
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R190932-0
MN
Other
Enumeration date
10/06/2010
Last updated
10/06/2010
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