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Individual

TARA FORSTIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
19829 N 27TH AVE, PHOENIX, AZ 85027-4001
(602) 769-1137
Mailing address
515 E CAREFREE HWY # 299, PHOENIX, AZ 85085-8839
(602) 769-1137

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
1161
CO
363LA2100X
Acute Care Nurse Practitioner
RN00000099202
AZ
363LP0200X
Pediatric Nurse Practitioner
9886
MN
363LP0200X
Pediatric Nurse Practitioner
Primary
AP8273
AZ
363LP0200X
Pediatric Nurse Practitioner
R53837
ND

Other

Enumeration date
10/13/2015
Last updated
03/27/2023
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