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Individual

TARA L EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
474 N YELLOW SPRINGS ST, SPRINGFIELD, OH 45504-2463
(937) 399-9500
Mailing address
3210 N STATE ROUTE 560, URBANA, OH 43078-9369

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN.369924
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.026062
OH

Other

Enumeration date
11/21/2018
Last updated
12/10/2019
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