Healthcare Provider Details

I. General information

NPI: 1932792215
Provider Name (Legal Business Name): TARAH LYNN ANDERSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2021
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9058 OLD LEE HWY
OOLTEWAH TN
37363-5631
US

IV. Provider business mailing address

1025 PEERLESS XING NW
CLEVELAND TN
37312-3764
US

V. Phone/Fax

Practice location:
  • Phone: 423-531-9110
  • Fax: 423-531-9115
Mailing address:
  • Phone: 423-476-5990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number38112
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: