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General NPI Number Information
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NPI Number | 1386962140
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Entity Type | Individual
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Provider Name | TARA LEIGH BRANNEN APRN
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Gender | Female
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Dates
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Enumeration Date | 05/04/2010
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 139 CENTRE ST PH 120
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City | NEW YORK
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State | NY
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Zip | 10013-4559
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Country | US
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Telephone | 888-731-8994
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Fax |
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Provider Business Mailing Address
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Address Line | 445 S FIGUEROA ST FL 31
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City | LOS ANGELES
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State | CA
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Zip | 90071-1602
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Country | US
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Telephone | 888-731-8994
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Fax | 833-775-1861
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9218740
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9218740
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License Number State | FL
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