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Individual

TARA M LEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
19550 E 39TH ST S STE 200, INDEPENDENCE, MO 64057-2358
(816) 833-0466
(816) 833-4155
Mailing address
19550 E 39TH ST S, SUITE 105-A, INDEPENDENCE, MO 64057-2303
(816) 833-0466
(816) 833-4155

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2000158992
MO
363L00000X
Nurse Practitioner
45836
KS

Other

Enumeration date
06/24/2006
Last updated
04/11/2023
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