Individual
TARA ELIZABETH BYROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
4444 E 41ST ST, TULSA, OK 74135-2527
(918) 619-4400
(918) 619-4334
Mailing address
11911 S OAK ST, JENKS, OK 74037-2667
(918) 851-2425
(918) 619-4334
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
2013042963
MO
363LP0200X
Pediatric Nurse Practitioner
201401241NP-PP
OR
363LP0200X
Pediatric Nurse Practitioner
Primary
75260
OK
363LP0200X
Pediatric Nurse Practitioner
NP847716
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200478980A
—
OK
Enumeration date
02/21/2013
Last updated
07/13/2021
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