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NPI Code Detail

MEDICARE: MRS. TARA NICHOLE MEREDITH ACNP-C

MEDICARE: MRS. TARA NICHOLE MEREDITH ACNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner18921SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164824421
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TARA NICHOLE MEREDITH ACNP-C
Provider Business Mailing Address
First Line : 300 E MCBEE AVE FL 4
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-2842
Country : US
Telephone Number : 864-522-8603
Fax Number :
Provider Business Practice Location Address
First Line : 3 RICHLAND MEDICAL PARK DR STE 510
Second Line :
City : COLUMBIA
State : SC
Zip : 29203-6854
Country : US
Telephone Number : 803-296-2726
Fax Number : 803-296-3319
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2014
Last Update Date : 02/01/2023

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Directions to “ MRS. TARA NICHOLE MEREDITH ACNP-C” Practice Location

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