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General NPI Number Information
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NPI Number | 1548342009
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Entity Type | Individual
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Provider Name | TARA A CLEARY GNP
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Gender | Female
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 101 CABARRUS AVE E
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City | CONCORD
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State | NC
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Zip | 28025-3699
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Country | US
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Telephone | 984-243-2962
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Fax |
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Provider Business Mailing Address
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Address Line | 7004 BARTONS GROVE PL
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City | RALEIGH
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State | NC
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Zip | 27614-7259
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Country | US
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Telephone | 917-747-7545
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 5009027
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | F340505
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License Number State | NY
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