Provider Demographics
NPI:1376252098
Name:MARR-CARTER, TARA LYNN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:LYNN
Last Name:MARR-CARTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:TARA
Other - Middle Name:LYNN
Other - Last Name:MARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:403 FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-2399
Mailing Address - Country:US
Mailing Address - Phone:370-538-6011
Mailing Address - Fax:
Practice Address - Street 1:403 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2399
Practice Address - Country:US
Practice Address - Phone:910-592-6011
Practice Address - Fax:910-592-0811
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017369363LF0000X
NC253092163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily