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Individual
TARA DAWN BOLAND
Active
Individual
TARA DAWN BOLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
207405
OK
367A00000X
Advanced Practice Midwife
207405
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R211050
STATE LICENSE
MD
Enumeration date
07/03/2019
Last updated
12/08/2025
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