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Individual
MRS. TARA MARIE ICE
Active
Individual
MRS. TARA MARIE ICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
11045463
FL
363LP1700X
Perinatal Nurse Practitioner
Primary
11045463
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/29/2025
Last updated
05/18/2026
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