TARA FENNER (NPI# 1417423153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417423153 |
| Entity Type | Individual |
| Full Name | TARA FENNER |
| Credential | FNP-C |
| Practice Address |
6265 39th St Groves TX 77619-4614 |
| Practice Telephone | 4099624400 |
| Practice Fax Number | 4099624412 |
| Mailing Telephone | 4099624400 |
| Enumeration Date | 2018-10-20 |
| Last Update Date | 2020-05-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP140593 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2555 Jimmy Johnson Blvd, Port Arthur, TX 776402007 | 4098535628 |
| Street Address |
6265 39TH ST |
| City | GROVES |
| State | TX |
| Zip Code | 77619-4614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710977913 | Roussel Clement | Internal Medicine | 6265 39th St, Groves, TX 77619-4614 | 2005-10-27 |
| 1609474634 | Mercedes Ludivina Clement | Counselor | 6265 39th St, Groves, TX 77619-4614 | 2020-10-12 |
| 1043858798 | My Hien Nguyen | Nurse Practitioner | 6265 39th St, Groves, TX 77619-4614 | 2019-12-12 |
| 1265860571 | Phuong Tran | Nurse Practitioner | 6265 39th St, Groves, TX 77619-4614 | 2013-10-23 |
| 1720147762 | Roussel Clement Mdpa | Internal Medicine | 6265 39th St, Groves, TX 77619-4614 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821565458 | Ahmed Zead Issa | Non-emergency Medical Transport (VAN) | 3947 Main Ave, Groves, TX 77619 | 2018-11-01 |
| 1467981878 | John Erick Thomson | Physical Therapy Assistant | 4301 Mckinley Ave, Groves, TX 77619 | 2017-06-08 |
| 1992066872 | Big Hill Bayou Emergency Physicians | Emergency Medicine | 5590 39th Street, Groves, TX 77619 | 2012-06-06 |
| 1861581027 | Gregory L Hollier | Chiropractor | 4820 Tiwn City Hwy, Groves, TX 77619 | 2006-10-12 |
| 1447879689 | Ashley Wagner | Licensed Vocational Nurse | 2726 3rd Ave, Groves, TX 77619-2614 | 2020-04-08 |
| 1295816312 | Groves Er Physicians Group P A | Emergency Medicine | 5500 39th Street, Groves, TX 77619-2905 | 2006-10-17 |
| 1639172778 | Renaissance Hospitals Inc | General Acute Care Hospital | 5500 39th St, Groves, TX 77619-2905 | 2005-05-23 |
| 1275854663 | Freedom Er Physicians Pllc | Emergency Medicine | 5500 39th St, Groves, TX 77619-2905 | 2010-06-20 |
| 1336476845 | Kiglapait Hospital Corporation | General Acute Care Hospital | 5500 39th St, Groves, TX 77619-2905 | 2009-11-05 |
| 1639310634 | Lthm Groves - Operations LLC | Psychiatric Unit | 5500 39th St, Groves, TX 77619-2905 | 2009-03-20 |
| Find all providers in zip 77619 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043858798 | My Hien Nguyen | Nurse Practitioner | 6265 39th St, Groves, TX 77619-4614 | 2019-12-12 |
| 1326579244 | Lacomb Health & Wellness, Pllc | Nurse Practitioner | 6000 39th St, Groves, TX 77619-4600 | 2017-03-22 |
| 1265860571 | Phuong Tran | Nurse Practitioner | 6265 39th St, Groves, TX 77619-4614 | 2013-10-23 |
| 1619993003 | Christine Rhea Lacomb | Nurse Practitioner | 6000 39th St, Groves, TX 77619-4600 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255162 | Shaida Rahmatinick | Nurse Practitioner | 1515 W 22nd St, Houston, TX 77008-1501 | 2020-11-08 |
| 1891396586 | Stacey Lynne Ready | Nurse Practitioner | 200 Uptmore Rd, West, TX 76691-2339 | 2020-11-08 |
| 1992306609 | Jillian Mcclintock | Nurse Practitioner | 2506 Graystone Ln, Corinth, TX 76210-1607 | 2020-11-08 |
| 1851992515 | Stacie A Gregg | Nurse Practitioner | 1229 Johnny Ln, San Angelo, TX 76905-2331 | 2020-11-07 |
| 1285235929 | Activate Family Health, Pllc | Nurse Practitioner | 203 E Davis St Ste F-1026, Conroe, TX 77301-3159 | 2020-11-07 |
| 1629679782 | Kristen Aili Johnson | Nurse Practitioner | 3850 Fm 18, Abilene, TX 79602-2004 | 2020-11-05 |
| 1376144303 | Stephanie Renee Knight | Nurse Practitioner | 4326 Egret Dr, Seabrook, TX 77586-2557 | 2020-11-05 |
| 1457952319 | Olufunke Oyindamola Oshoba | Nurse Practitioner | 200 Odyssey Ln, Mansfield, TX 76063-3438 | 2020-11-05 |
| 1518568419 | Ian Mardis | Nurse Practitioner | 12528 Tierra Encino Dr, El Paso, TX 79938-4525 | 2020-11-05 |
| 1851992994 | Angela Davis | Nurse Practitioner | 9523 Scanlan Heights Ln, Missouri City, TX 77459-5503 | 2020-11-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.