Nichols, Tara Lynn

Nichols, Tara Lynn is an individual health care provider with primary practice located at 2600 6Th St Sw , Canton OH 44710-1702. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Nichols, Tara Lynn can be contacted via phone (330) 363-1342.

Contact Information

Primary practice address
2600 6Th St Sw Canton OH 44710-1702
Phone: (330) 363-1342
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 365623 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN.CNP.020528 Ohio

Profile Details

NPI number 1205364007
LBN Legal business name Nichols, Tara Lynn
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2017
Last updated Nov 23rd, 2022 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1205364007 NPPES
Ohio MEDICAID 1205364007

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