Healthcare Provider Details

I. General information

NPI: 1437532868
Provider Name (Legal Business Name): EMMALEE M. TARRA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMMALEE M. KELLY CNP

II. Dates (important events)

Enumeration Date: 07/02/2015
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 WATER ST
MILFORD MA
01757-3039
US

IV. Provider business mailing address

PO BOX 415348
BOSTON MA
02241-5348
US

V. Phone/Fax

Practice location:
  • Phone: 508-334-2527
  • Fax: 774-442-3687
Mailing address:
  • Phone: 800-225-8885
  • Fax: 508-334-8105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2289191
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: