Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 20A14620 | CA |
N | 2080N0001X | Neonatal-Perinatal Doctor | 2019019570 | MO |
N | 2080P0204X | Pediatric Emergency Doctor | 2019019570 | MO |
NPI | 1205249398 |
---|---|
Provider Name | Dr. Tara Lynn Billings |
First Address | Saint Louis, MO 63110-1002 |
Second Address | Palm Springs, CA 92262-5752 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2014 |
Last Update Date | 10/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200070391 | (05) | MO |