Provider Demographics
NPI:1689330318
Name:WEBSTER, TARA MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:MARIE
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 WILLOW WOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-5059
Mailing Address - Country:US
Mailing Address - Phone:267-885-5416
Mailing Address - Fax:
Practice Address - Street 1:1600 ROCKLAND RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3607
Practice Address - Country:US
Practice Address - Phone:302-651-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELJ-0010404363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics