Provider Demographics
NPI:1982902748
Name:CONLEY, TARA BETH (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:BETH
Last Name:CONLEY
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 NEW BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5814
Mailing Address - Country:US
Mailing Address - Phone:508-679-0911
Mailing Address - Fax:508-536-0310
Practice Address - Street 1:373 NEW BOSTON RD
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5814
Practice Address - Country:US
Practice Address - Phone:508-679-0911
Practice Address - Fax:508-536-0310
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN260208363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology