Individual provider · NPI-1

Tara Marlaine Albert, CPNP

Nurse Practitioner, Pediatrics · Saint Louis, MO

NPI number1124294764
StatusActive
Last updated in NPPESJun 2, 2011

Details

NPI
1124294764
Entity type
Individual (NPI-1)
Name
Mrs. Tara Marlaine Albert
Credential
CPNP
Sex
Female
Sole proprietor
No
Enumeration date
May 4, 2008
Last updated
Jun 2, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics151691MOYes

Practice location

621 S New Ballas Rd
Suite 537a
Saint Louis, MO 63141-8232

Phone 314-251-6990 · Fax 314-251-6998

Mailing address

621 S New Ballas Rd
Suite 537a
Saint Louis, MO 63141-8232

Phone 314-251-6990 · Fax 314-251-6998

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