Tara Lynn Pettit CRNA, MSN

NPI 1205155223 - Registered Nurse - 163W00000X

NPI Details
NPI 1205155223
Gender Female
Enumeration Date 06/01/2010
Last Updated 04/25/2016
Entity Type Individual
Active Over 6 years ago
Practice Location
310 WOODSTOWN RD
SALEM NJ, 08079, US
Phone (856) 935-1000
Fax
Business Location
11781 LEE JACKSON MEMORIAL HWY
SUITE 550
FAIRFAX VA, 22033-3309, US
Phone (571) 777-5106
Fax (856) 968-8499
Toxanomy
Taxonomy Code 163W00000X
License State New Jersey
License Number 26NR11265000
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According to our database, Mrs. Tara Lynn Pettit CRNA, MSN NPI is 1205155223, taxonomy code is 163W00000X and license number is 26NR11265000, license state is located at New Jersey. Tara Lynn Pettit CRNA, MSN physically located at 310 Woodstown Rd, Salem NJ, 08079. NPI Number Tara Lynn Pettit CRNA, MSN has the Individual type.

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1205155223 NPI number is provided on an as is basis without warranty of any kind. 1205155223 is maintained by the National Plan & Provider Enumeration System. The contents of Tara Lynn Pettit CRNA, MSN are for informational purposes only.