Healthcare Provider Details

I. General information

NPI: 1699371385
Provider Name (Legal Business Name): TARA LYNN ZEHMISCH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARA L ZEHMISCH CRNP

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5375 E ERICKSON DR
TUCSON AZ
85712-2838
US

IV. Provider business mailing address

2905 SUN CREST DR
SIERRA VISTA AZ
85650-6853
US

V. Phone/Fax

Practice location:
  • Phone: 520-324-5585
  • Fax:
Mailing address:
  • Phone: 520-732-8819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP030590
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number252068
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: