Provider Demographics
NPI:1730472374
Name:TARNO, KATHLEEN THERESA-BUSHA (RN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:THERESA-BUSHA
Last Name:TARNO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2055
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58402-2055
Mailing Address - Country:US
Mailing Address - Phone:701-253-6308
Mailing Address - Fax:701-253-6400
Practice Address - Street 1:520 3RD AVE NW
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-3016
Practice Address - Country:US
Practice Address - Phone:701-253-6308
Practice Address - Fax:701-253-6400
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR33420163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse