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NPI Code Detail

MEDICARE: TARA RENEE OHNEMUS LPN

MEDICARE: TARA RENEE OHNEMUS LPN
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
1164W00000XLicensed Practical Nurse043.103952IL

General Provider Information

NPI Number : 1447115985
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA RENEE OHNEMUS LPN
Provider Business Mailing Address
First Line : 6020 BROADWAY ST
Second Line :
City : QUINCY
State : IL
Zip : 62305-7919
Country : US
Telephone Number : 217-224-3366
Fax Number : 217-221-6191
Provider Business Practice Location Address
First Line : 6020 BROADWAY ST
Second Line :
City : QUINCY
State : IL
Zip : 62305-7919
Country : US
Telephone Number : 217-224-3366
Fax Number : 217-221-6191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2025
Last Update Date : 12/17/2025

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Directions to “ TARA RENEE OHNEMUS LPN” Practice Location

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