| NPI | 1013416718 |
|---|---|
| Former Name | TARA LYN MADDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21479) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC F11170386) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2022-11-04 |