Individual
MRS. TARA MACSEENE GRGURICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
14288 SHIBLEY RD, GREEN CASTLE, MO 63544-3141
(660) 488-6598
Mailing address
1104 N BALTIMORE ST, KIRKSVILLE, MO 63501-2528
(660) 216-9300
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2013012835
MO
Other
Enumeration date
05/20/2013
Last updated
10/05/2022
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