Provider Demographics
NPI:1225261068
Name:ROOF-STRICKLAND, TARA LYNNE (RN)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:LYNNE
Last Name:ROOF-STRICKLAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13168 STATE ROUTE 279
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:OH
Mailing Address - Zip Code:45656-8504
Mailing Address - Country:US
Mailing Address - Phone:740-577-6713
Mailing Address - Fax:740-932-4001
Practice Address - Street 1:13168 STATE ROUTE 279
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:OH
Practice Address - Zip Code:45656-8504
Practice Address - Country:US
Practice Address - Phone:740-577-6713
Practice Address - Fax:740-932-4001
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN307532163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse