| Doctor Name: | TARA EISENLOHR |
| NPI Number: | 1043617129 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 118962 |
| Business Practice Address: | 1631 4th St Sw Suite 114b Mason City, IA - 504011612 |
| Business Phone Number: | 6414286000 |
| Business Fax Number: | 6414286007 |
| Mailing Address: | 621 S Illinois Ave, Suite 103 MASON CITY |
| State: | IA |
| Postal Code: | 504015405 |
| Phone Number: | 6414283041 |
| Fax Number: | 6414283059 |
| NPI Enumeration Date: | 12/04/2014 |
| NPI Last Update Date: | 12/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 118962 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |