Provider Demographics
NPI:1609145671
Name:PARKER, TARA LYNNE (RN,BSN, APN, NP-C)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:LYNNE
Last Name:PARKER
Suffix:
Gender:F
Credentials:RN,BSN, APN, NP-C
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:LYNNE
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP-C
Mailing Address - Street 1:3458 NEELY RD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08641-5312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3458 NEELY RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08641-5312
Practice Address - Country:US
Practice Address - Phone:646-605-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF310241207R00000X
FLAPRN11013191207R00000X
NJ26NJ00359200207R00000X
NJ26NO11482300163WF0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WF0300XNursing Service ProvidersRegistered NurseFlight
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine