Provider Demographics
NPI:1689164774
Name:CRIMMINS, TARA LYNN (RRT)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:LYNN
Last Name:CRIMMINS
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:MS
Other - First Name:TARA
Other - Middle Name:LYNN
Other - Last Name:HIGDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2300 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47111-9810
Mailing Address - Country:US
Mailing Address - Phone:812-256-1106
Mailing Address - Fax:
Practice Address - Street 1:2300 MARKET ST
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:IN
Practice Address - Zip Code:47111-9810
Practice Address - Country:US
Practice Address - Phone:812-256-1106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN30007494A227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered