Healthcare Provider Details

I. General information

NPI: 1467486357
Provider Name (Legal Business Name): TARA MCGAHEY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 4TH AVE N
NAPLES FL
34102-5729
US

IV. Provider business mailing address

4371 VERONICA S SHOEMAKER BLVD
FORT MYERS FL
33916-2216
US

V. Phone/Fax

Practice location:
  • Phone: 239-434-2622
  • Fax: 239-434-2587
Mailing address:
  • Phone: 239-274-8200
  • Fax: 239-278-3224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberANTI1475492
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: