Provider Demographics
NPI:1386311686
Name:DIEHL, TARA ROSE (CRNP)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:ROSE
Last Name:DIEHL
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:ROSE
Other - Last Name:MCGUIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:271 PARK TERRACE CT
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:PA
Mailing Address - Zip Code:18014-1210
Mailing Address - Country:US
Mailing Address - Phone:610-360-5822
Mailing Address - Fax:
Practice Address - Street 1:2649 SCHOENERSVILLE RD STE 100
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7326
Practice Address - Country:US
Practice Address - Phone:484-884-8110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024094363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily