Provider Demographics
NPI:1790398337
Name:DUFFIE, TARA (DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:
Last Name:DUFFIE
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 TERRACE PL
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2412
Mailing Address - Country:US
Mailing Address - Phone:615-322-2571
Mailing Address - Fax:
Practice Address - Street 1:2015 TERRACE PL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2412
Practice Address - Country:US
Practice Address - Phone:615-322-2571
Practice Address - Fax:615-322-1326
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN240651163WP0808X
TN28100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health