Individual
MRS. TARA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
292 BROOKS MALOTT RD, MOUNT ORAB, OH 45154-9580
(937) 444-0035
Mailing address
311 DEER CREEK DR, AMELIA, OH 45102-2684
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
18394
OH
Other
Enumeration date
11/19/2015
Last updated
12/29/2015
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