TARA MARIE KELLER (NPI# 1417575549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417575549 |
| Entity Type | Individual |
| Full Name | TARA MARIE KELLER |
| Credential | PA-C |
| Practice Address |
78 Omega Dr Bldg C Newark DE 19713-2064 |
| Practice Telephone | 3023682883 |
| Practice Fax Number | 3023682892 |
| Mailing Telephone | 3023682883 |
| Mailing Fax Number | 3023682892 |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
C50011410 | DE | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DE | STATE LICENSE | C50011410 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538705561 | Tara Caroline Keller | Nurse Anesthetist, Certified Registered | 234 Goodman St, Cincinnati, OH 45219-2364 | 2019-11-25 |
| 1366834012 | Tara Keller | Physical Therapist | 3636 N Ridge Rd, Building 400, Wichita, KS 67205-1213 | 2015-03-04 |
| 1467766113 | Tara Keller | Counselor | 1800 N 16th St, Suite 1, Clarinda, IA 51632-1101 | 2010-08-04 |
| Street Address |
78 OMEGA DR BLDG C |
| City | NEWARK |
| State | DE |
| Zip Code | 19713-2064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912068529 | Stephanie A Lee | Internal Medicine | 78 Omega Dr Bldg C, Newark, DE 19713-2064 | 2006-12-13 |
| 1710596895 | Alyssa N Floyd | Physician Assistant | 78 Omega Dr Bldg C, Newark, DE 19713-2064 | 2020-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574490 | Stacie Guyton | Nurse Practitioner | 4501 Ogletown Stanton Road, Newark, DE 19713 | 2020-09-25 |
| 1225674633 | Michael Francis Stant | Specialist/Technologist | Delaware Field House, 617 South College Avenue Rm 111b, Newark, DE 19713 | 2019-11-20 |
| 1528559457 | Sarah Mun | Physician Assistant | 4755 Ogletown Stanton Rd, Newark, DE 19713 | 2018-05-26 |
| 1568983286 | Clarice Wanisku Kariuki | Licensed Practical Nurse | 15 Prestbury Square, Suite 14, Nweark, DE 19713 | 2017-07-03 |
| 1679029870 | Auxilia Akala | Nurse Practitioner | 1082 Churchmans Rd, Newrk, DE 19713 | 2016-08-28 |
| 1003369851 | Yawar Abbas | Psychiatry & Neurology | Rockford Center, 100 Rockford Dr, Newark, DE 19713 | 2016-07-28 |
| 1700245925 | Debra Hutz | Counselor | 25 Omega Dr., Professional Center #j, Newark, DE 19713 | 2016-02-16 |
| 1376918201 | Aquiles Igleisias | Speech-Language Pathologist | 540 South College Avenue, Newark, DE 19713 | 2015-12-03 |
| 1639547359 | Kylee Rose | Social Worker | 901 S. Chapel Street, Newark, DE 19713 | 2015-09-11 |
| 1932503976 | Kathleen Madara | Physical Therapist | 540 S College Ave, Suite 210, University of Delaware, Newark, DE 19713 | 2014-10-20 |
| Find all providers in zip 19713 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457702177 | Jacinta Hollinger | Physician Assistant | C78-80 Omega Dr, Newark, DE 19713-2076 | 2016-06-23 |
| 1851709877 | Bethany Anne Melo | Physician Assistant | 4755 Ogletown Stanton Rd Fl 3, Newark, DE 19718-2200 | 2014-07-23 |
| 1437442357 | Sherifa P Julien-johnson | Physician Assistant | 238 Mulberry St, Newark, NJ 07102-3528 | 2011-05-25 |
| 1821319997 | Melva M Brown | Physician Assistant | 354 Doremus Ave, Newark, NJ 07105-4882 | 2010-06-11 |
| 1437303302 | Helen Brightman | Physician Assistant | 150 Bergen St # H245, Newark, NJ 07103-2496 | 2008-11-05 |
| 1669657623 | John Stewart Constance | Physician Assistant | Christiana Care Health System Dept of Medicine, 4755 Ogletown-stanton Rd., Newark, DE 19718-0001 | 2008-01-08 |
| 1114935152 | Susan E Matarese | Physician Assistant | 1200 Peoples Plz, Suite 1285, Newark, DE 19702-5701 | 2006-08-04 |
| 1306453766 | Justin Michael Pipoli | Physician Assistant | 4755 Ogletown Stanton Rd, Newark, DE 19718-2200 | 2020-09-29 |
| 1710596895 | Alyssa N Floyd | Physician Assistant | 78 Omega Dr Bldg C, Newark, DE 19713-2064 | 2020-07-24 |
| 1649898834 | Nicholas D Biermann | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2020-07-14 |
| Find all providers in NEWARK | ||||
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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.