Provider Demographics
NPI:1699371385
Name:ZEHMISCH, TARA LYNN (CRNP)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:LYNN
Last Name:ZEHMISCH
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:L
Other - Last Name:ZEHMISCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:2905 SUN CREST DR
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85650-6853
Mailing Address - Country:US
Mailing Address - Phone:520-732-8819
Mailing Address - Fax:
Practice Address - Street 1:5375 E ERICKSON DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2838
Practice Address - Country:US
Practice Address - Phone:520-324-5585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP030590363L00000X
AZ252068363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner