MEDICARE: MS. TARA BOLSINGER

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	363LF0000X	Family Nurse Practitioner	APRN.COA.15649	OH

General Provider Information

NPI Number	:	1306260195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TARA BOLSINGER

Provider Business Mailing Address
First Line	:	3417 SNOOK RD
Second Line	:
City	:	MORROW
State	:	OH
Zip	:	45152-9570
Country	:	US
Telephone Number	:	513-404-1900
Fax Number	:

Provider Business Practice Location Address
First Line	:	87 E US HIGHWAY 22 AND 3
Second Line	:	SUITE 800
City	:	MAINEVILLE
State	:	OH
Zip	:	45039-7841
Country	:	US
Telephone Number	:	513-677-9117
Fax Number	:	513-677-0045

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

Provider Enumeration Date	:	02/13/2014
Last Update Date	:	10/10/2022

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Directions to “ MS. TARA BOLSINGER ” Practice Location

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