Individual
TARA RAE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1698 E MCANDREWS RD STE 400, MEDFORD, OR 97504-5590
(541) 732-7400
(541) 732-3410
Mailing address
1698 E MCANDREWS RD STE 400, MEDFORD, OR 97504-5590
(541) 732-7400
(541) 732-3410
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
10018842APRN-NP
OR
363LW0102X
Women's Health Nurse Practitioner
AP 07195
LA
363LW0102X
Women's Health Nurse Practitioner
AP61501809
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10018842
OREGON BOARD OF NURSING
OR
05
—
2337483
—
LA
01
—
AP61501809
WASHINGTON BOARD OF NURSING
WA
01
—
PA 080109
LOUISIANA STATE BOARD OF NURSING PRESCRIPTIVE AUTHORITY
LA
Enumeration date
02/04/2013
Last updated
03/12/2024
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