Individual
MS. TARA WATERS MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
300 GREENO RD S, FAIRHOPE, AL 36532-1905
(251) 929-3424
Mailing address
300 GREENO RD S, FAIRHOPE, AL 36532-1905
(251) 929-3424
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1116286
AL
363LF0000X
Family Nurse Practitioner
Primary
1-116286
AL
Other
Enumeration date
07/26/2017
Last updated
10/20/2020
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