Provider Demographics
NPI:1982958799
Name:NAGEL, TARA RAE (CPNP)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:RAE
Last Name:NAGEL
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
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Mailing Address - Street 1:4214 MAMIES CIR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707
Mailing Address - Country:US
Mailing Address - Phone:432-620-8687
Mailing Address - Fax:432-682-1831
Practice Address - Street 1:4214 MAMIES CIR
Practice Address - Street 2:MIDLAND PEDIATRIC ASSOCIATES
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707
Practice Address - Country:US
Practice Address - Phone:432-620-8687
Practice Address - Fax:432-682-1831
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX756895363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics