Individual
MRS. TAMMY IRENE HARGENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
103843
IA
367500000X
Certified Registered Nurse Anesthetist
Primary
3005296
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
077220
CRNA CERTIFICATE
IA
01
—
P00433525
RAILROAD MEDICARE
IA
Enumeration date
03/15/2007
Last updated
06/02/2015
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