Trout, Tara Jo
Trout, Tara Jo is an individual health care provider with primary practice located at 1701 Cornwall Rd Suite 101, Lebanon PA 17042-7480. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Trout, Tara Jo can be contacted via phone (717) 675-1788.Contact Information
Primary practice address
1701 Cornwall Rd Suite 101
Lebanon PA 17042-7480
Phone: (717) 675-1788
Fax: (717) 675-1800
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | MA052621 | Pennsylvania |
Profile Details
| NPI number | 1801803432 |
|---|---|
| LBN Legal business name | Trout, Tara Jo |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2006 |
| Last updated | Aug 31st, 2016 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801803432 | NPPES |
| Pennsylvania | Other | MA052621 | PHYSICIAN ASSISTANT LICEN |
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