Provider Demographics
NPI:1760367023
Name:PARKER, TARA
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2282
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27878-2282
Mailing Address - Country:US
Mailing Address - Phone:252-266-3934
Mailing Address - Fax:
Practice Address - Street 1:1424 TREETOP LN
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-8842
Practice Address - Country:US
Practice Address - Phone:252-266-3934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide