Provider Demographics
NPI:1982442406
Name:BURKE, TARA MEGAN
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:MEGAN
Last Name:BURKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TREVECCA NAZARENE UNIVERSITY PA PROGRAM
Mailing Address - Street 2:333 MURFREESBORO PIKE
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:TREVECCA NAZARENE UNIVERSITY PA PROGRAM
Practice Address - Street 2:333 MURFREESBORO PIKE
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210
Practice Address - Country:US
Practice Address - Phone:615-248-1225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program