Tara Gann
Nurse Practitioner - Primary Care
405 W Main St Ste B
Payson
, Arizona 85541-5345
Tara Gann
Nurse Practitioner - Primary Care
405 W Main St Ste B
Payson
, Arizona 85541-5345
(928) 951-2189
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About
Features
Specialties
- Nurse Practitioner - Primary Care
Languages spoken
- English
Location
First Address
- Tara Gann
- 1503 W Country Club Dr
- Payson, AZ
- Zip : 85541-4611
- Phone : (928) 951-2189
Second Address
- Tara Gann
- 405 W Main St Ste B
- Payson, AZ
- Zip : 85541-5345
- Fax : (844) 752-8246
- Phone : (928) 472-6000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP2300X | Nurse Practitioner - Primary Care | AP7879 | AZ |
National Provider Identifier
| NPI | 1043691520 |
|---|---|
| Provider Name | Tara Gann |
| First Address | Payson, AZ 85541-4611 |
| Second Address | Payson, AZ 85541-5345 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/06/2015 |
| Last Update Date | 13/09/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.