Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 5086 | NV |
N | 1223D0001X | Dental Public Health | DE00009193 | WA |
NPI | 1306981659 |
---|---|
Provider Name | Dr. Tara Lynn Vanorden |
First Address | Reno, NV 89502-1117 |
Second Address | Reno, NV 89502-1117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 19/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004716904 | (05) | NV |