MEDICARE: TARA MCLAMB N.P.

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	189175	NC

General Provider Information

NPI Number	:	1326356940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA MCLAMB N.P.

Provider Business Mailing Address
First Line	:	PO BOX 250
Second Line	:
City	:	BEAVER
State	:	PA
Zip	:	15009-0250
Country	:	US
Telephone Number	:	800-634-0201
Fax Number	:	866-727-0896

Provider Business Practice Location Address
First Line	:	208 COX BLVD
Second Line	:	STE 102
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-9414
Country	:	US
Telephone Number	:	919-731-6018
Fax Number	:	919-580-7010

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

Provider Enumeration Date	:	09/16/2010
Last Update Date	:	09/08/2016

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