Provider Demographics
NPI:1740481621
Name:GUNTHNER, TARA MARY (RN)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:MARY
Last Name:GUNTHNER
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 1:20 PRINCE RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4516
Mailing Address - Country:US
Mailing Address - Phone:732-238-0074
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY HEALTH SERVICES
Practice Address - Street 2:WASHINGTON RD
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08544-0001
Practice Address - Country:US
Practice Address - Phone:609-258-3139
Practice Address - Fax:609-258-0842
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07327600163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health