MEDICARE: TIARA HERRING NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209023011	IL
2	363LA2200X	Adult Health Nurse Practitioner	209023011	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225613953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIARA HERRING NP

Provider Business Mailing Address
First Line	:	11313 USA PKWY STE E148
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46037-9208
Country	:	US
Telephone Number	:	317-781-4500
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 N KEYSTONE AVE STE 100
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-2499
Country	:	US
Telephone Number	:	219-315-6581
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2021
Last Update Date	:	03/06/2026

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Directions to “ TIARA HERRING NP” Practice Location

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