Individual
TARA LYNN ILIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
228 SAINT CHARLES WAY STE 300, YORK, PA 17402-4661
(717) 812-5400
(717) 741-3598
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP019068
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103545113
—
PA
Enumeration date
09/10/2018
Last updated
03/09/2023
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