Provider Demographics
NPI:1639749716
Name:ZAJAC, TARA KARYN (RN)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:KARYN
Last Name:ZAJAC
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:573 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:AMBRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15003-1566
Mailing Address - Country:US
Mailing Address - Phone:724-712-7777
Mailing Address - Fax:
Practice Address - Street 1:573 RIDGE RD
Practice Address - Street 2:
Practice Address - City:AMBRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15003-1566
Practice Address - Country:US
Practice Address - Phone:724-712-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA682522163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse