Healthcare Provider Details

I. General information

NPI: 1861990558
Provider Name (Legal Business Name): TARA LEIGH STRICKLAND ARNP, FNP-BC, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2018
Last Update Date: 01/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HEALTH PARK BLVD
SAINT AUGUSTINE FL
32086-5784
US

IV. Provider business mailing address

400 HEALTH PARK BLVD STE 300
SAINT AUGUSTINE FL
32086-5784
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-4085
  • Fax: 904-819-5056
Mailing address:
  • Phone: 904-819-4085
  • Fax: 904-819-5056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9346708
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: