Provider Demographics
NPI:1821283870
Name:MULDER, TAERA A (PA-C)
Entity Type:Individual
Prefix:MS
First Name:TAERA
Middle Name:A
Last Name:MULDER
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4200
Mailing Address - Fax:615-823-5572
Practice Address - Street 1:1215 PLEASANT ST STE 100
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1409
Practice Address - Country:US
Practice Address - Phone:515-336-6557
Practice Address - Fax:515-461-2223
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2023-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA001847363A00000X, 363A00000X
COPA0004392363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant