MEDICARE: MS. TARA LYNN HALPIN PA

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	363A00000X	Physician Assistant	0010-07511	NC

General Provider Information

NPI Number	:	1750518841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TARA LYNN HALPIN PA

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	704-316-3070
Fax Number	:	704-316-3071

Provider Business Practice Location Address
First Line	:	330 BILLINGSLEY RD STE 202
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-5020
Country	:	US
Telephone Number	:	704-316-3070
Fax Number	:	704-316-3071

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

Provider Enumeration Date	:	06/16/2009
Last Update Date	:	09/21/2023

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