Provider Demographics
NPI:1760997563
Name:VERDOLINI, TARA LYNN (CRNP)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:LYNN
Last Name:VERDOLINI
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Gender:F
Credentials:CRNP
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Mailing Address - Street 1:1456 FERRY RD STE 600
Mailing Address - Street 2:DOYLESTOWN HEALTH INTERNAL MEDICINE FOUNTAINVILLE
Mailing Address - City:FOUNTAINVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18923
Mailing Address - Country:US
Mailing Address - Phone:215-230-8390
Mailing Address - Fax:215-230-8392
Practice Address - Street 1:1456 FERRY ROAD
Practice Address - Street 2:SUITE 600
Practice Address - City:FOUNTAINVILLE
Practice Address - State:PA
Practice Address - Zip Code:18923
Practice Address - Country:US
Practice Address - Phone:215-230-8390
Practice Address - Fax:215-230-8392
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2020-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP018538363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner