TARA YVETTE MABON


Address: 2500 Peres Ave, Memphis, TN 38108-1660
Phone: 9015155500

TARA YVETTE MABON (NPI# 1619136306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619136306
Entity Type Individual
Full Name TARA YVETTE MABON
Credential FNP
Practice Address 2500 Peres Ave
Memphis
TN 38108-1660
Mailing Address 877 Jefferson Ave
Attn: Provider Enrollment
Memphis
TN 38103-2807
Practice Telephone 9015155500
Practice Fax Number 9014585591
Enumeration Date 2008-06-06
Last Update Date 2017-01-03
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
0000013381 TN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 2500 PERES AVE
City MEMPHIS
State TN
Zip Code 38108-1660

Providers in the same location

NPI Name Taxonomy Address Enumeration
1467446716 Banani Dirghangi Pediatrics 2500 Peres Ave, Memphis, TN 38108-1660 2005-09-01
1548681315 Davin P Johnson Advanced Practice Midwife 2500 Peres Ave, Memphis, TN 38108-1660 2013-12-21
1508203621 Jacqueline Ann Scott Registered Nurse 2500 Peres Ave, Memphis, TN 38108-1660 2013-05-30
1700197530 Oluwayemisi Emereuwaonu Pediatrics 2500 Peres Ave, Memphis, TN 38108-1660 2010-06-26
1831345776 Robert Brown Nurse Practitioner 2500 Peres Ave, Memphis, TN 38108-1660 2008-08-12
1033397880 Meghan Marie Madea Nurse Practitioner 2500 Peres Ave, Memphis, TN 38108-1660 2008-02-04
1073523882 Amy L Devore Advanced Practice Midwife 2500 Peres Ave, Memphis, TN 38108-1660 2006-08-08
1154315067 Bharathi Rangaswami Family Medicine 2500 Peres Ave, Memphis, TN 38108-1660 2005-09-07

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1295208429 Danny Winston B Robillo Physical Therapist 1143 Cully Road, Cordova, TN 38108 2019-01-10
1114235363 Nikita Nicole Bratcher-johnson Occupational Therapist 1755 Eldridge Ave, Memphis, TN 38108-1115 2010-09-22
1770608457 St. Clare Health and Rehab, LLC. Intermediate Care Facility, Mental Illness 1755 Eldridge Ave., Memphis, TN 38108-1115 2007-03-20
1093255101 Ave Maria Home Dba St. Clare Health and Rehab, LLC Skilled Nursing Facility 1755 Eldridge Ave, Memphis, TN 38108-1115 2017-03-08
1033643549 One and Only Resources Inc Home Health 1463 Britton St, Memphis, TN 38108-1304 2017-04-12
1154812790 Brittany Sneed Adult Companion 2030 Nedra Ave, Memphis, TN 38108-1347 2018-05-18
1184117731 Supportive Homecare, LLC Adult Companion 2030 Nedra Ave, Memphis, TN 38108-1347 2018-06-08
1700872975 Gloria J Pryor Dentist 2410 Chelsea Ave, Memphis, TN 38108-1515 2005-09-23
1326404963 Nicholas Cornell Brooks Dentist 2410 Chelsea Ave, Memphis, TN 38108-1515 2016-01-12
1538331533 G J Pryor Clinic/Center 2410 Chelsea Ave, Memphis, TN 38108-1515 2008-03-31
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1730787193 Nancy Katherine Ray Nurse Practitioner 4576 Poplar Ave, Memphis, TN 38117-7502 2020-10-16
1245837533 Sandra Dee Garrison Nurse Practitioner 335 Lillian Dr, Memphis, TN 38109-4431 2020-10-08
1972119527 Oneka E Poindexter Nurse Practitioner 86 N Rembert St, Memphis, TN 38104-2766 2020-09-18
1295346260 Jimarie Nelson Nurse Practitioner 5100 Poplar Ave Ste 2007, Memphis, TN 38137-2007 2020-08-13
1346869187 Tollaria Williams Nurse Practitioner 3797 Old Waverly Cv Apt 201, Memphis, TN 38125-2678 2020-04-12
1497388912 Michelle Denise Jones Nurse Practitioner 493 Doctor M.l.k. Jr Ave, Memphis, TN 38126-3812 2020-02-13
1336781657 J Wilson Health LLC Nurse Practitioner 5100 Poplar Ave, Fl 27 Ste 2719a, Memphis, TN 38137-2701 2019-10-09
1265081574 Natalie Staten Nurse Practitioner 7651 Shelby Forest Cv, Memphis, TN 38125-2822 2019-09-09
1881247740 Mekeilah Nevaun Johnson Nurse Practitioner 6005 Park Ave Ste 825b, Memphis, TN 38119-5223 2019-07-19
1205488087 Wendy Powell Nurse Practitioner 1407 Union Ave Ste 405, Memphis, TN 38104-3627 2019-07-12
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Competitor

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City MEMPHIS
Zip Code 38108

Improve Information

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Dataset Information

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.

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