What is Tara Dettra's NPI number?

Tara Dettra's National Provider Identifier (NPI) is 1790929438, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Tara Dettra's specialty?

Tara Dettra is listed in the NPPES registry with a primary specialty of Midwife (Other Service Providers).

Where is Tara Dettra located?

Tara Dettra's practice location on file with NPPES is 1093 A1a Beach Blvd, Saint Augustine, FL 32080-6733.

What is Tara Dettra's phone number?

The practice phone number listed in the NPPES registry for Tara Dettra is (904) 540-7994.

Is Tara Dettra's NPI active?

Yes — Tara Dettra's NPI (1790929438) is active in the NPPES registry as of the last update on 2009-04-24.

IndividualActive

Tara Dettra, L.M., C.P.M.

NPI 1790929438 · Midwife · Saint Augustine, FL

Tara Dettra, L.M., C.P.M. is a Midwife provider in Saint Augustine, FL (NPI 1790929438).

Provider details

NPI number: 1790929438
Entity type: Individual
Primary specialty: MidwifeOther Service Providers
Credential: L.M., C.P.M.
Sex: Female
Sole proprietor: Yes
License: MW 227 (FL)

Specialties & taxonomies

MidwifePrimary176B00000XLicense MW 227 (FL)
Other Service Providers

Profile Score

Detailed profile(85/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
17 yrs in NPPES registry
Profile completeness38% of score
100% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

1093 A1a Beach Blvd

Pmb 285

Saint Augustine, FL 32080-6733

Phone: (904) 540-7994

Fax: (904) 471-4980

Approximate (ZIP-level) locationGet directions

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Mailing address