Provider Demographics
NPI:1710409628
Name:MCGLOCKING, TARSHA P
Entity Type:Individual
Prefix:MRS
First Name:TARSHA
Middle Name:P
Last Name:MCGLOCKING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 PRINCESS LUISE LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-7123
Mailing Address - Country:US
Mailing Address - Phone:386-627-5921
Mailing Address - Fax:866-728-3578
Practice Address - Street 1:22 PRINCESS LUISE LANE
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164
Practice Address - Country:US
Practice Address - Phone:386-627-5921
Practice Address - Fax:866-728-3578
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL234626376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker