Provider Demographics
NPI:1154821510
Name:AMATO, TARAH M (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:TARAH
Middle Name:M
Last Name:AMATO
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2501
Mailing Address - Country:US
Mailing Address - Phone:614-596-2416
Mailing Address - Fax:
Practice Address - Street 1:1885 HENDERSON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2501
Practice Address - Country:US
Practice Address - Phone:145-962-4166
Practice Address - Fax:614-293-4812
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022579363L00000X, 363LF0000X
OHF12170510363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner