Individual
MRS. TARA LEIGH MARION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.N.P.
Contact information
Practice address
6960 SILOAM RD, SILOAM, NC 27047-9193
(336) 374-3338
Mailing address
6960 SILOAM RD, SILOAM, NC 27047-9193
(336) 374-3338
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
5005289
NC
Other
Enumeration date
09/11/2011
Last updated
09/11/2011
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