Perdue, Tara

Perdue, Tara is an individual health care provider with primary practice located at 913 N Dixie Ave , Elizabethtown KY 42701-2503. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Perdue, Tara can be contacted via phone (877) 783-6257.

Contact Information

Primary practice address
913 N Dixie Ave Elizabethtown KY 42701-2503
Phone: (877) 783-6257
Fax: (859) 514-5521
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 50.003403 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 50003403 Ohio

Profile Details

NPI number 1346509221
LBN Legal business name Perdue, Tara
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2012
Last updated Oct 12th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346509221 NPPES
Ohio MEDICAID 0086921
Ohio MEDICAID 7100353530

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