Provider Demographics
NPI:1245939230
Name:HAYES, TARA LYNN (DNP FNP)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:LYNN
Last Name:HAYES
Suffix:
Gender:F
Credentials:DNP FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 VARSITY WAY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32306-0001
Mailing Address - Country:US
Mailing Address - Phone:850-980-2701
Mailing Address - Fax:
Practice Address - Street 1:1630 RIGGINS RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5316
Practice Address - Country:US
Practice Address - Phone:850-878-4434
Practice Address - Fax:949-655-8526
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11024221363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily