MEDICARE: MRS. TARA R BEIGHTOL NP

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	7800	TN

General Provider Information

NPI Number	:	1578542056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TARA R BEIGHTOL NP

Provider Business Mailing Address
First Line	:	4230 HARDING PIKE STE 527
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-2098
Country	:	US
Telephone Number	:	615-386-3067
Fax Number	:	615-385-0612

Provider Business Practice Location Address
First Line	:	4230 HARDING PIKE STE 527
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-2098
Country	:	US
Telephone Number	:	615-386-3067
Fax Number	:

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

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	04/22/2020

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