Provider Demographics
NPI:1881707289
Name:ROBERTS, TARA LYNN (MSN, RN, ANP-BC)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:LYNN
Last Name:ROBERTS
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Gender:F
Credentials:MSN, RN, ANP-BC
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Mailing Address - Street 1:2641 RAVENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-7926
Mailing Address - Country:US
Mailing Address - Phone:512-656-1710
Mailing Address - Fax:254-743-0016
Practice Address - Street 1:1901 VETERANS MEMORIAL DR
Practice Address - Street 2:112
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7451
Practice Address - Country:US
Practice Address - Phone:254-295-3372
Practice Address - Fax:254-743-0016
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2011-06-24
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Provider Licenses
StateLicense IDTaxonomies
TX604528363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health