Provider Demographics
NPI:1720485642
Name:BRONSON, TARA ELIZABETH (MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:ELIZABETH
Last Name:BRONSON
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Gender:F
Credentials:MSN, FNP-C
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Mailing Address - Street 1:200 MILL RD STE 180
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5255
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:714 AQUIDNECK AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5796
Practice Address - Country:US
Practice Address - Phone:401-846-1139
Practice Address - Fax:401-847-1360
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2020-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN257511363LF0000X
RINPP37870363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily