Provider Demographics
NPI:1306260195
Name:BOLSINGER, TARA
Entity type:Individual
Prefix:MS
First Name:TARA
Middle Name:
Last Name:BOLSINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:3417 SNOOK RD
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-9570
Mailing Address - Country:US
Mailing Address - Phone:513-404-1900
Mailing Address - Fax:
Practice Address - Street 1:87 E US HIGHWAY 22 AND 3
Practice Address - Street 2:SUITE 800
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-7841
Practice Address - Country:US
Practice Address - Phone:513-677-9117
Practice Address - Fax:513-677-0045
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.COA.15649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily