Provider Demographics
NPI:1881866655
Name:LYNCHARD, TARA L (CNM, FNP-C)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:L
Last Name:LYNCHARD
Suffix:
Gender:F
Credentials:CNM, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43526-1250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:419-542-6544
Practice Address - Street 1:208 COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43526-1250
Practice Address - Country:US
Practice Address - Phone:419-542-7718
Practice Address - Fax:419-542-6544
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13337367A00000X, 363LF0000X
OHCOA.12713-NP363LF0000X
OHCOA.12714-NM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily