MEDICARE: TARA CAPALDI NP-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
1	363LA2200X	Adult Health Nurse Practitioner	4704308864	MI
2	363LA2200X	Adult Health Nurse Practitioner	71005898A	IN

General Provider Information

NPI Number	:	1265810584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA CAPALDI NP-C

Provider Business Mailing Address
First Line	:	2741 W LAYTON AVE STE 106
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-2600
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8800 VIRGINIA PL
Second Line	:
City	:	MERRILLVILLE
State	:	IN
Zip	:	46410-7109
Country	:	US
Telephone Number	:	414-242-5468
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2015
Last Update Date	:	07/01/2025

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Directions to “ TARA CAPALDI NP-C” Practice Location

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