Individual provider · NPI-1

Dr. Tarra Louisa Deiter-Enright, D.O.

Internal Medicine · Cody, WY

NPI number1609063825
StatusActive
Last updated in NPPESMay 14, 2024

Details

NPI
1609063825
Entity type
Individual (NPI-1)
Name
Dr. Tarra Louisa Deiter-Enright
Credential
D.O.
Sex
Female
Sole proprietor
No
Enumeration date
Oct 2, 2007
Certification date
May 14, 2024
Last updated
May 14, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine14504AWYYes

Practice location

424 Yellowstone Ave Ste 230
Cody, WY 82414-9310

Phone 307-578-2975 · Fax 307-578-2979

Mailing address

424 Yellowstone Ave Ste 230
Cody, WY 82414-9310

Phone 307-578-2975 · Fax 307-578-2979

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