Provider Demographics
NPI:1720453632
Name:LEMASTER, TARA (FNP)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:LEMASTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:CORDLE (MAIDEN)
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1595
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:
Practice Address - Street 1:617 23RD ST STE 215
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2870
Practice Address - Country:US
Practice Address - Phone:606-408-4260
Practice Address - Fax:606-408-6327
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009925363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner