Provider Demographics
NPI:1164721981
Name:KAISER, TARA LYNN (ARNP)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:LYNN
Last Name:KAISER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-2056
Mailing Address - Country:US
Mailing Address - Phone:319-277-0991
Mailing Address - Fax:319-266-5452
Practice Address - Street 1:1824 W 8TH ST
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2056
Practice Address - Country:US
Practice Address - Phone:319-277-0991
Practice Address - Fax:319-266-5452
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA116569363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily