Individual
TARAH LYNN HERDEGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
9850 W ST LUKES DR STE 180, NAMPA, ID 83687-7912
(208) 322-1680
Mailing address
9850 W ST LUKES DR STE 180, NAMPA, ID 83687-7912
(208) 322-1680
(208) 461-8194
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
00000
ID
363LF0000X
Family Nurse Practitioner
Primary
55734
ID
Other
Enumeration date
09/29/2021
Last updated
04/26/2022
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