Healthcare Provider Details

I. General information

NPI: 1275972192
Provider Name (Legal Business Name): TARA L THOMAS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARA L SCHNITKER

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 HEALTHCARE DR STE 204
BIDDEFORD ME
04005-9450
US

IV. Provider business mailing address

61 WATSON RD
NORWAY ME
04268-4426
US

V. Phone/Fax

Practice location:
  • Phone: 207-284-2630
  • Fax: 207-294-3566
Mailing address:
  • Phone: 207-807-8773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN56106
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP131046
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: