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NPI Code Detail

MEDICARE: TARA JAMES FNP

MEDICARE: TARA JAMES FNP
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
1363LF0000XFamily Nurse Practitioner902693MS
2363LF0000XFamily Nurse Practitioner9494499FL

General Provider Information

NPI Number : 1518433804
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA JAMES FNP
Provider Business Mailing Address
First Line : 3512 S ATLANTIC AVE
Second Line :
City : DAYTONA BEACH SHORES
State : FL
Zip : 32118-7639
Country : US
Telephone Number : 386-767-9544
Fax Number : 386-767-9914
Provider Business Practice Location Address
First Line : 3512 S ATLANTIC AVE
Second Line :
City : DAYTONA BEACH SHORES
State : FL
Zip : 32118-7639
Country : US
Telephone Number : 386-767-9544
Fax Number : 386-767-9914
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2018
Last Update Date : 05/19/2022

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