Provider Demographics
NPI:1982288171
Name:PHILCOX, TARA ANN (APRN PMHNP)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:ANN
Last Name:PHILCOX
Suffix:
Gender:F
Credentials:APRN PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:9079 N DICKENS DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34434-4943
Mailing Address - Country:US
Mailing Address - Phone:305-560-7583
Mailing Address - Fax:352-218-7635
Practice Address - Street 1:9079 N DICKENS DR
Practice Address - Street 2:
Practice Address - City:CITRUS SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34434-4943
Practice Address - Country:US
Practice Address - Phone:305-560-7583
Practice Address - Fax:352-218-7635
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013056364SP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health