Albert, Tara Marlaine

Albert, Tara Marlaine is an individual health care provider with primary practice located at 621 S New Ballas Rd Suite 537A, Saint Louis MO 63141-8232. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Albert, Tara Marlaine can be contacted via phone (314) 251-6990.

Contact Information

Primary practice address
621 S New Ballas Rd Suite 537A Saint Louis MO 63141-8232
Phone: (314) 251-6990
Fax: (314) 251-6998
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 151691 Missouri

Profile Details

NPI number 1124294764
LBN Legal business name Albert, Tara Marlaine
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2008
Last updated Jun 2nd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124294764 NPPES
Missouri MEDICAID 1124294764

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