Individual provider · Type 1 NPI
Tara Mallory
Licensed Practical Nurse · Roscommon, MI
NPI number
1982563433
Active
Practice location
5705 September Ln
Roscommon, MI 48653-8756
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Practical Nurse Primary | 164W00000X | 4703083153 (MI) |
Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
Other licensed practical nurse providers in Roscommon
About NPI 1982563433
Tara Mallory's National Provider Identifier is 1982563433, issued on Jan 20, 2026. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Roscommon, MI. The record was last updated on Jan 20, 2026.