Provider Demographics
NPI:1679055529
Name:ENGLAND, TARA LEA
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:LEA
Last Name:ENGLAND
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 1:401 MULBERRY ST SW STE 210
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5463
Mailing Address - Country:US
Mailing Address - Phone:828-757-6431
Mailing Address - Fax:828-757-6432
Practice Address - Street 1:401 MULBERRY ST SW STE 207
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5463
Practice Address - Country:US
Practice Address - Phone:828-757-6462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010943363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner