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Tara Autumn Mendoza, FNP
Family Nurse Practitioner in Bedford, Indiana
NPI 1366742488

Tara Autumn Mendoza is a Family Nurse Practitioner based in Bedford, IN and is specialized in Family. Tara Autumn Mendoza practices in Bedford, IN and has the professional credentials of FNP. The NPI Number for Tara Autumn Mendoza is 1366742488 and holds a License No. 71003400A (Indiana).

The current practice location address for Tara Autumn Mendoza is 2418 16 Street, Bedford, IN and can be reached out via phone at 812-508-8683.

Location: 2418 16 Street, Bedford, IN, 47421-3049
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366742488
Provider Name
Tara Autumn Mendoza
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
2418 16 Street, Bedford, IN, 47421-3049
Phone Number
812-508-8683
Fax Number
Provider Enumeration Date
10/22/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
201019690 05 IN
institution
Provider Business Practice Location Address Details
Address
2418 16 Street
City
Bedford
State
Indiana
Zip
47421
Phone Number
812-508-8683
Fax Number
person
Provider Business Mailing Address Details
Address
2418 16 Street
City
Bedford
State
Indiana
Zip
47421
Phone Number
812-508-8683
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
71003400A (Indiana)
Definition
Definition to come...
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