Provider Demographics
NPI:1003531377
Name:DURLEY, TARA EMILIA
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:EMILIA
Last Name:DURLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 DELUCCHI LN STE 218
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-8521
Mailing Address - Country:US
Mailing Address - Phone:775-686-6021
Mailing Address - Fax:
Practice Address - Street 1:1575 DELUCCHI LN STE 218
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-8521
Practice Address - Country:US
Practice Address - Phone:775-686-6021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV374U00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide