Individual
TAMARA TARA MANNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
537 CUMBERLAND DR, SHREVEPORT, LA 71106-5919
(318) 560-0409
Mailing address
425 PLAZA CIR, BOSSIER CITY, LA 71111-4811
(419) 307-4980
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
RN150117
LA
Other
Enumeration date
02/25/2021
Last updated
02/25/2021
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