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General NPI Number Information
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NPI Number | 1255812129
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Entity Type | Individual
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Provider Name | TARA E SPALDING PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 11803 JEFFERSON AVE STE 230
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4390
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Country | US
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Telephone | 757-534-7701
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Fax | 757-534-7708
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Provider Business Mailing Address
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Address Line | 4374 NEW TOWN AVE
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-2865
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10002506A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110007328
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License Number State | VA
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