Provider Demographics
NPI:1427102896
Name:TARR, ESSIE (ARNP MS BC CHT)
Entity type:Individual
Prefix:MS
First Name:ESSIE
Middle Name:
Last Name:TARR
Suffix:
Gender:F
Credentials:ARNP MS BC CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7681 1ST TERRACE
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-8101
Mailing Address - Country:US
Mailing Address - Phone:561-969-9067
Mailing Address - Fax:561-969-9067
Practice Address - Street 1:7681 1ST TERRACE
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-8101
Practice Address - Country:US
Practice Address - Phone:561-969-9067
Practice Address - Fax:561-969-9067
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1593972363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL76380600Medicaid
Y4597ZMedicare ID - Type Unspecified
FL76380600Medicaid