Individual
TARA LYNN FISHWILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 STONECREST BLVD STE 250, SMYRNA, TN 37167-6832
(615) 917-6020
Mailing address
300 STONECREST BLVD STE 250, SMYRNA, TN 37167-6832
(629) 220-0211
(629) 220-0210
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
32393
TN
Other
Enumeration date
09/13/2022
Last updated
11/04/2022
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