Kidd, Tara Nicole

Kidd, Tara Nicole is an sole proprietor health care provider with primary practice located at 907 Mar Walt Dr Ste 2013 , Fort Walton Beach FL 32547-6756. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Kidd, Tara Nicole can be contacted via phone (817) 354-5200.

Contact Information

Primary practice address
907 Mar Walt Dr Ste 2013 Fort Walton Beach FL 32547-6756
Phone: (817) 354-5200
Fax: (773) 492-8765
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 1098257 Texas
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN11027520 Florida

Profile Details

NPI number 1285341826
LBN Legal business name Kidd, Tara Nicole
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2022
Last updated Feb 22nd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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