Individual
TARA KEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3 RIVERSIDE CIR, ROANOKE, VA 24016-4955
(540) 224-5170
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
0024174587
VA
363LA2200X
Adult Health Nurse Practitioner
0024174587
VA
363LG0600X
Gerontology Nurse Practitioner
Primary
0024174587
VA
Other
Enumeration date
03/07/2017
Last updated
11/11/2025
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