Provider Demographics
NPI:1982827408
Name:TARPEY, MORIAH LOUISE (MD)
Entity type:Individual
Prefix:DR
First Name:MORIAH
Middle Name:LOUISE
Last Name:TARPEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MORIAH
Other - Middle Name:LOUISE
Other - Last Name:HEYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1311 N MILDRED RD
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-2231
Mailing Address - Country:US
Mailing Address - Phone:970-565-6666
Mailing Address - Fax:
Practice Address - Street 1:1311A N MILDRED RD
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-2231
Practice Address - Country:US
Practice Address - Phone:970-565-8665
Practice Address - Fax:970-564-1134
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO48027208000000X
WAMD60719667208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07137745Medicaid
WA2078096Medicaid