Individual
MRS. TARA M LIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1580 COMMANCHE AVE, GREEN BAY, WI 54313-5751
(920) 435-8326
(920) 430-4659
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
161162
CO
363LA2200X
Adult Health Nurse Practitioner
Primary
3618
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A1105073
AMERICAN ACADEMY OF NURSE PRACTITIONERS
—
Enumeration date
09/28/2007
Last updated
04/18/2023
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