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Individual
TARA CHILDERS
Active
Individual
TARA CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
AG09240028
AL
363LG0600X
Gerontology Nurse Practitioner
AG09240028
AL
363LP2300X
Primary Care Nurse Practitioner
Primary
AG09240028
AL
Other
Enumeration date
09/12/2022
Last updated
09/23/2024
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