Tara-Germaine St. Rose, NP
Nurse Practitioner, Women's Health in New York, NY. Individual provider (NPI-1).
NPI number1982178273
StatusActive
Last updated in NPPESJun 8, 2021
Details
- NPI
- 1982178273
- Entity type
- Individual (NPI-1)
- Name
- Ms. Tara-Germaine St. Rose
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 20, 2019
- Certification date
- Jun 8, 2021
- Last updated
- Jun 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LW0102X | Nurse Practitioner, Women's Health | 421421 | NY | Yes |
| 363LW0102X | Nurse Practitioner, Women's Health | pending | MD |
Other names
- Tara Germaine St. Rose (Former Name)
Practice location
111 Broadway Fl 4New York, NY 10006-1978
Phone 212-263-9700
Mailing address
111 Broadway Fl 4New York, NY 10006-1978
Other practice locations
330 N Howard St
Baltimore, MD 21201-3610
Baltimore, MD 21201-3610
Phone 410-576-1414
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