Individual
MISS TARA DANIELLE WINGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4202 E CACTUS RD APT 7308, PHOENIX, AZ 85032-0616
(870) 917-7118
Mailing address
4202 E CACTUS RD APT 7308, PHOENIX, AZ 85032-0616
(870) 917-7118
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L47240
AR
Other
Enumeration date
10/10/2008
Last updated
10/10/2008
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