| NPI | 1033555966 |
|---|---|
| Former Name | TARA JANAE CLEVELAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004739A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71004739A) |
| Enumeration Date | 2013-05-19 |
| Last Update Date | 2020-10-05 |