Provider Demographics
NPI:1932818911
Name:ESSIE TARR
Entity Type:Organization
Organization Name:ESSIE TARR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:ESSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TARR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:561-444-3293
Mailing Address - Street 1:7681 1ST TER
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-8101
Mailing Address - Country:US
Mailing Address - Phone:561-444-3293
Mailing Address - Fax:561-969-9067
Practice Address - Street 1:7681 1ST TER
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-8101
Practice Address - Country:US
Practice Address - Phone:561-444-3293
Practice Address - Fax:561-969-9067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024637600Medicaid