Individual
TARA M GROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1313 FISH HATCHERY RD, MADISON, WI 53715-1911
(608) 252-8000
(608) 283-7318
Mailing address
1313 FISH HATCHERY RD, MADISON, WI 53715-1911
(608) 252-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3843-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497980031
—
WI
Enumeration date
05/27/2009
Last updated
11/18/2020
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