Basic Information
| Provider Information | |||||||||
| NPI: | 1861572984 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRABTREE-VOLLRATH | ||||||||
| FirstName: | TARA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | APRN, NP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CRABTREE | ||||||||
| OtherFirstName: | TARA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | APRN, NP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2060 READING RD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452021454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137213200 | ||||||||
| FaxNumber: | 5136393186 | ||||||||
| Practice Location | |||||||||
| Address1: | 7459 STATE RD | ||||||||
| Address2: | SUITE 325 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452302154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132332000 | ||||||||
| FaxNumber: | 5136242684 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2006 | ||||||||
| LastUpdateDate: | 03/21/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | COA.09119-NP | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.