Provider Demographics
NPI:1992199418
Name:PATTERSON, TARA
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 NOAH AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-2002
Mailing Address - Country:US
Mailing Address - Phone:216-438-1513
Mailing Address - Fax:
Practice Address - Street 1:276 NOAH AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-2002
Practice Address - Country:US
Practice Address - Phone:216-438-1513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker