Provider Demographics
NPI:1043555709
Name:ENGELBART, TARAN L (APN, FNP-BC)
Entity type:Individual
Prefix:
First Name:TARAN
Middle Name:L
Last Name:ENGELBART
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 CRESCENT OAK LN
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-4300
Mailing Address - Country:US
Mailing Address - Phone:773-896-6592
Mailing Address - Fax:
Practice Address - Street 1:2375 EDGEWOOD RD SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-4736
Practice Address - Country:US
Practice Address - Phone:773-896-6592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60490365363LF0000X
IAA169395363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily