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General NPI Number Information
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NPI Number | 1932829363
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Entity Type | Organization
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Legal Business Name | TARA LYNN BURKHOLDER PSYCHIATRIC SERVICES LLC
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 253 ANN DR
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City | GREENSBURG
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State | PA
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Zip | 15601-6659
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Country | US
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Telephone | 878-214-1304
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Fax |
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Provider Business Mailing Address
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Address Line | 253 ANN DR
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City | GREENSBURG
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State | PA
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Zip | 15601-6659
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Country | US
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Telephone | 878-214-1304
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CHARLES BURKHOLDER
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Credential |
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Telephone | 724-516-8492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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