Provider Demographics
NPI:1265689640
Name:BARACH, TAMARA S (RN BSN CRRN)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:S
Last Name:BARACH
Suffix:
Gender:F
Credentials:RN BSN CRRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3639
Mailing Address - Country:US
Mailing Address - Phone:614-846-3924
Mailing Address - Fax:614-846-6048
Practice Address - Street 1:230 COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3639
Practice Address - Country:US
Practice Address - Phone:614-846-3924
Practice Address - Fax:614-846-6048
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 173453163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse