Healthcare Provider Details

I. General information

NPI: 1205292752
Provider Name (Legal Business Name): TARA FIORE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 N DUKE ST
LANCASTER PA
17602-2250
US

IV. Provider business mailing address

555 N DUKE ST
LANCASTER PA
17602-2250
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-4305
  • Fax: 717-544-4312
Mailing address:
  • Phone: 717-544-4305
  • Fax: 717-544-4312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN588538
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: