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NPI Code Detail

MEDICARE: TARREN PRANGE APNP

MEDICARE: TARREN PRANGE APNP
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 Practitioner8327WI
2363LF0000XFamily Nurse Practitioner209018037IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18327-33OTHERWIAPNP LICENSE

General Provider Information

NPI Number : 1922573625
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARREN PRANGE APNP
Provider Business Mailing Address
First Line : 2020 E GRAND AVE
Second Line :
City : LINDENHURST
State : IL
Zip : 60046-9069
Country : US
Telephone Number : 847-356-4302
Fax Number :
Provider Business Practice Location Address
First Line : 2020 E GRAND AVE
Second Line :
City : LINDENHURST
State : IL
Zip : 60046-9069
Country : US
Telephone Number : 847-356-4302
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2018
Last Update Date : 10/18/2023

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