Healthcare Provider Details

I. General information

NPI: 1932032026
Provider Name (Legal Business Name): TARA R ARP CPRC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7091 W EMERALD ST
BOISE ID
83704-8618
US

IV. Provider business mailing address

219 21ST AVE S
NAMPA ID
83651-4408
US

V. Phone/Fax

Practice location:
  • Phone: 208-379-0783
  • Fax:
Mailing address:
  • Phone: 208-585-8041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number13079
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: