Provider Demographics
NPI:1285932681
Name:NELSON-NERENBERG, TARA LEE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:LEE
Last Name:NELSON-NERENBERG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E BESSEMER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-7001
Mailing Address - Country:US
Mailing Address - Phone:336-275-7644
Mailing Address - Fax:336-275-9390
Practice Address - Street 1:901 E BESSEMER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-7001
Practice Address - Country:US
Practice Address - Phone:336-275-7644
Practice Address - Fax:336-275-9390
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17382183500000X
NY050079-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist