Individual
TARA SIMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
640 JACKSON STREET MAIL STOP 13901C, ST. PAUL, MN 55101-2502
(651) 254-3456
Mailing address
PO BOX 1309 - MAIL STOP 21110Q, MINNEAPOLIS, MN 55440
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R202537-1
MN
367500000X
Certified Registered Nurse Anesthetist
120873
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
2239
MN
Other
Enumeration date
01/15/2017
Last updated
09/24/2018
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