Provider Demographics
NPI:1679159982
Name:TARA B FERTILITY PLLC
Entity Type:Organization
Organization Name:TARA B FERTILITY PLLC
Other - Org Name:TARA B FERTILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARDING
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-C
Authorized Official - Phone:701-471-9745
Mailing Address - Street 1:3000 N 14TH ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0697
Mailing Address - Country:US
Mailing Address - Phone:701-471-9745
Mailing Address - Fax:
Practice Address - Street 1:116 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:ASHLEY
Practice Address - State:ND
Practice Address - Zip Code:58413-7318
Practice Address - Country:US
Practice Address - Phone:701-471-9745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty