Healthcare Provider Details

I. General information

NPI: 1881254290
Provider Name (Legal Business Name): TARA KARR MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 06/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 N DUNLAP ST
MEMPHIS TN
38105-4625
US

IV. Provider business mailing address

51 N DUNLAP ST FL 3
MEMPHIS TN
38105-4624
US

V. Phone/Fax

Practice location:
  • Phone: 901-287-5985
  • Fax: 901-287-6650
Mailing address:
  • Phone: 901-287-5985
  • Fax: 901-287-6650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number2955
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: