| NPI | 1174739239 |
|---|---|
| Former Name | TARA SHEPHARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP112022) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC NP500014523) |
| 363L00000X Nurse Practitioner (Licence: FL APRN11024750) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024190458) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK R0069453) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F383654-01) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2024-11-05 |