Individual
TARA L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4000 CAMBRIDGE ST, KANSAS CITY, KS 66160-8501
(913) 588-1227
Mailing address
7221 HOLMES RD, KANSAS CITY, MO 64131-1675
(816) 276-7410
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2012041039
MO
363LF0000X
Family Nurse Practitioner
53-75820-112
KS
Other
Enumeration date
07/17/2012
Last updated
12/19/2025
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