MEDICARE: ROCHELLE LEE TATARKA APRN-CNP, PMHNP

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	163W00000X	Registered Nurse	RN.380183	OH
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0032193	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588191233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROCHELLE LEE TATARKA APRN-CNP, PMHNP

Provider Business Mailing Address
First Line	:	1616 GARMAN RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44313-6302
Country	:	US
Telephone Number	:	330-774-1743
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 S MILLER RD SUITE G
Second Line	:
City	:	FAIRLAWN
State	:	OH
Zip	:	44333-4180
Country	:	US
Telephone Number	:	330-414-6781
Fax Number	:

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

Provider Enumeration Date	:	05/12/2017
Last Update Date	:	05/07/2023

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