Provider Demographics
NPI:1174171748
Name:COVEY, TARA LYN (FNP)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:LYN
Last Name:COVEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:TARA
Other - Middle Name:LYN
Other - Last Name:NORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13090 PETIGRU ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4436
Mailing Address - Country:US
Mailing Address - Phone:317-733-8608
Mailing Address - Fax:
Practice Address - Street 1:13090 PETIGRU ST # 1
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4436
Practice Address - Country:US
Practice Address - Phone:317-733-8608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28160883A163W00000X
IN71009513A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse