Provider Demographics
NPI:1609328079
Name:HARPIS, TARA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:TARA
Middle Name:
Last Name:HARPIS
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 1:27 APPLE MEADOW RD APT D4
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-5213
Mailing Address - Country:US
Mailing Address - Phone:518-965-0471
Mailing Address - Fax:
Practice Address - Street 1:27 APPLE MEADOW RD APT D4
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-5213
Practice Address - Country:US
Practice Address - Phone:518-965-0471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311594164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse