Provider Demographics
NPI:1437925088
Name:DILLARD, TARAH (LPN)
Entity Type:Individual
Prefix:MISS
First Name:TARAH
Middle Name:
Last Name:DILLARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7949 STILLWELL RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-1149
Mailing Address - Country:US
Mailing Address - Phone:513-499-4048
Mailing Address - Fax:
Practice Address - Street 1:7949 STILLWELL RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-1149
Practice Address - Country:US
Practice Address - Phone:513-499-4048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.151053.IV-MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse