Individual provider · Type 1 NPI

Tara Lynn Dea, MSN, CRNP, PNP-BC

Pediatric Nurse Practitioner · Philadelphia, PA

NPI number 1326114281 Active

Practice location

34th St & Civic Center Blvd, Department Of Endocrinology
Philadelphia, PA 19104-4399

Mailing address

172 La Costa Dr
Blackwood, NJ 08012-5546

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200XSP009251 (PA)
Pediatric Nurse Practitioner 363LP0200X26NJ00306100 (NJ)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1326114281

Tara Lynn Dea, MSN, CRNP, PNP-BC's National Provider Identifier is 1326114281, issued on Nov 24, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Philadelphia, PA. The record was last updated on Dec 16, 2014.